Clinton Emmitt Branch Jr., M.D., F.A.A.N.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

016878 Issued in GA

Practice address

1240 Jesse Jewell Pkwy SE
Suite 400
Gainesville, GA 30501-3862

Phone

(770) 534-1117

Fax

(770) 503-7285

NPI assigned

Aug 20, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1184739435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 JESSE JEWELL PKWY SE",
            "address_2": "SUITE 400",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013862",
            "telephone_number": "770-534-1117",
            "fax_number": "770-503-7285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 JESSE JEWELL PKWY SE",
            "address_2": "SUITE 400",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013862",
            "telephone_number": "770-534-1117",
            "fax_number": "770-503-7285"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Patewood Dr Ste B350",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296156337",
            "country_code": "US",
            "telephone_number": "864-454-4500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRANCH",
        "first_name": "CLINTON",
        "middle_name": "EMMITT",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D., F.A.A.N.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2023-03-07",
        "certification_date": "2020-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "GA",
            "license": "016878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000178637F",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "13DDMF",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "016878",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wilmer D Bradley
• Ashlyn Bradshaw
• Shelia H Bradshaw, AGACNP-BC, DNP
• Evan Keith Brady, M.D.
• Vanessa Callahan Bragger, LMT
• Megan Branch, PT, DPT
• Brannon Pediatric Services, Inc.
• Tammy C Brannon, MS,PT
• Braselton Gainesville Emergency Department PC
• Davina Sara Braselton, PA-C

• Neurology Physician in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Neurology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.