Thomas Jesse Brandon, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

4704243187 Issued in MI

Practice address

10101 Renner Blvd
Lenexa, KS 66219-9752

Phone

(800) 873-8845

Fax

(913) 859-6887

NPI assigned

Mar 24, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Matrix Medical Plus

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1376973461

  MI

  Medicare reassignment NPD

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

{
    "created_epoch": "1427155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441497600000",
    "number": "1184018558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25373 VAN DYKE AVE",
            "city": "CENTER LINE",
            "state": "MI",
            "postal_code": "480151425",
            "telephone_number": "586-436-4469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 RENNER BLVD",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662199752",
            "telephone_number": "800-873-8845",
            "fax_number": "913-859-6887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDON",
        "first_name": "THOMAS",
        "middle_name": "JESSE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-24",
        "last_updated": "2015-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704243187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon Bradbury
• Braden Partners LP
• Brain First Family Center LLC
• Cynthia Michele Bramble, LPC
• Molly Brandenburg
• Judy Tinsley Brax, MHS, CCC-SLP
• Collin Breckenridge, DPT
• Brenda Casey Chiropractic PA
• Samuel Brethauer, ATC
• Jenny Lynn Brewer, MAMHC

• Gerontology Nurse Practitioner in Lenexa, KS
• Providers in Lenexa, KS by specialty
• Gerontology Nurse Practitioner in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.