Individual provider Active NPI

Brandee Shalese Pemberton, M.D.

  • Family Medicine Physician
  • Weatherford, TX
National Provider Identifier
1154883569
Registry record updated Oct 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
T9770 Issued in TX
Practice address
929 Hilltop Dr
Weatherford, TX 76086-5845
Phone
(817) 341-7670
Fax
(817) 341-7678
NPI assigned
Apr 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X T9770 TX Primary

Addresses

Primary practice location

929 Hilltop Dr
Weatherford, TX 76086-5845

Mailing address

929 Hilltop Dr
Weatherford, TX 76086-5845
Phone (817) 341-7670

Other practice location 1

7703 Floyd Curl Dr # 7795
San Antonio, TX 78229-3901
Phone (210) 358-3937

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220929002947 TX Practitioner - Family Practice 1951787852 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Star Family Medicine PLLCGroup PAC ID 7315296639, 2 clinicians

Practice addresses (Care Compare)

929 Hilltop Dr
Weatherford, TX 76086-5845
Phone (817) 341-7670

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Weatherford, TX, CCN 679523
  • Beyondfaith Homecare & Rehab of Ft Worth LLC Home health agency, Weatherford, TX, CCN 747521
  • Medical City Weatherford Hospital, Weatherford, TX, CCN 450203
  • Texas Health Harris Methodist Fort Worth Hospital, Fort Worth, TX, CCN 450135

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Star Family Medicine PLLC Family Medicine CurrentSince Oct 1, 2022 Accepting new patients

Locations

933 Hilltop Dr
Ste 100
Weatherford, TX 76086
Phone (817) 341-7302

929 Hilltop Dr
Weatherford, TX 76086
Phone (817) 341-7670

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17729/brand/1/csg/1/fhir/r4
  • Direct secure messaging: brandee.pemberton.1@17729.direct.athenahealth.com

Organizations & group practices 1

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1154883569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "929 HILLTOP DR",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760865845",
            "telephone_number": "817-341-7670",
            "fax_number": "817-341-7678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 HILLTOP DR",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760865845",
            "telephone_number": "817-341-7670",
            "fax_number": "817-341-7678"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7703 Floyd Curl Dr # 7795",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782293901",
            "country_code": "US",
            "telephone_number": "210-358-3937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEMBERTON",
        "first_name": "BRANDEE",
        "middle_name": "SHALESE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-03",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "T9770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weatherford, TX

Sources for this page

Verify at the official NPI Registry.