Individual provider Active NPI

Terrance Brafford

  • Home Health Aide
  • Granite City, IL
National Provider Identifier
1134769300
Registry record updated Jan 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
Practice address
2533 E 24TH St
Granite City, IL 62040-5638
Phone
(314) 397-8326
NPI assigned
Jan 15, 2020
Last updated
Jan 15, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X Primary

Addresses

Primary practice location

2533 E 24TH St
Granite City, IL 62040-5638

Mailing address

1342 Kingsland Ave
Saint Louis, MO 63133-1614
Phone (314) 479-5710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1579046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579046400000",
    "number": "1134769300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1342 KINGSLAND AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631331614",
            "telephone_number": "314-479-5710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2533 E 24TH ST",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620405638",
            "telephone_number": "314-397-8326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAFFORD",
        "first_name": "TERRANCE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-15",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granite City, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.