Individual provider Active NPI

Julia M Brannon, PHD

  • Psychologist
  • Reidsville, NC
National Provider Identifier
1073795514
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1396 Issued in NC
Practice address
1305 Coach Rd Ste a
Reidsville, NC 27320-5571
Phone
(336) 349-5553
Fax
(336) 349-5554
NPI assigned
Nov 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1396 NC Primary

Addresses

Primary practice location

1305 Coach Rd Ste a
Reidsville, NC 27320-5571

Mailing address

546 Sandy Cross Rd
Reidsville, NC 27320-5571
Phone (336) 951-0000

Other identifiers 1

IdentifierTypeStateIssuer
6000093MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040914000268 NC Practitioner - Clinical Psychologist 2769459387 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

134 Chrisfield Cir
Winston Salem, NC 27104-4464
Phone (336) 951-0000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1396NCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Julia Brannon PHD & Associates Incorporated CurrentSince Sep 1, 2005 Accepting new patients
Mental Health Specialty Group PA CurrentSince Aug 1, 2025 Accepting new patients

Locations

546 Sandy Cross Rd
Reidsville, NC 27320
Phone (336) 394-4503

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1196121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1073795514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "546 SANDY CROSS RD",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273205571",
            "telephone_number": "336-951-0000",
            "fax_number": "336-951-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 COACH RD STE A",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273205571",
            "telephone_number": "336-349-5553",
            "fax_number": "336-349-5554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANNON",
        "first_name": "JULIA",
        "middle_name": "M",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-27",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "1396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6000093",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reidsville, NC

Sources for this page

Verify at the official NPI Registry.