Individual provider Active NPI

Barbara Anne Brandon, D.O.

  • Sports Medicine (Family Medicine) Physician
  • Spokane, WA
National Provider Identifier
1114192218
Registry record updated Dec 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
OP60017447 Issued in WA
Practice address
5901 N Lidgerwood St Ste 126
Spokane, WA 99208-1122
Phone
(509) 444-8200
Fax
(509) 434-0392
NPI assigned
Apr 29, 2008
Last updated
Dec 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OP60017447 WA
Sports Medicine (Family Medicine) Physician 207QS0010X OP60017447 WA Primary

Addresses

Primary practice location

5901 N Lidgerwood St Ste 126
Spokane, WA 99208-1122

Mailing address

611 N Iron Bridge Way
Spokane, WA 99202-4932
Phone (509) 444-8888

Other identifiers 1

IdentifierTypeStateIssuer
OL20000099OtherWAMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081218000654 WA Practitioner - Family PracticePractitioner - Orthopedic Surgery 8527120930 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1502 N Vercler Rd
Spokane Valley, WA 99216-1078
Phone (509) 444-8204

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OP60017447WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Association of Spokane Current Accepting new patients
Community Health Association of Spokane Family Medicine CurrentSince Jun 23, 2020 Accepting new patients
Community Health Association of Spokane CurrentSince Jun 23, 2020 Accepting new patients
Inland Empire Hospital Services Association Family Medicine Past Accepting new patients

Locations

1001 W 2nd Ave
Spokane, WA 99201
Phone (509) 835-1205

5901 N Lidgerwood St
Ste 126
Spokane, WA 99208
Phone (509) 434-1990

611 N Iron Bridge Way
Spokane, WA 99202

1502 N Vercler Rd
Spokane Valley, WA 99216
Phone (509) 444-8204

Interoperability endpoints

  • Direct secure messaging: barbara.brandon.1@11411.direct.athenahealth.com

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1114192218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 N IRON BRIDGE WAY",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992024932",
            "telephone_number": "509-444-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 N LIDGERWOOD ST STE 126",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992081122",
            "telephone_number": "509-444-8200",
            "fax_number": "509-434-0392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDON",
        "first_name": "BARBARA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-29",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP60017447",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "WA",
            "license": "OP60017447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "OL20000099",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.