Individual provider Active NPI

Arthur L Brannon III

  • Surgery Physician
  • Washington, DC
National Provider Identifier
1285194621
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
D92461 Issued in MD
Practice address
3800 Reservoir Rd NW
Washington, DC 20007-2113
Phone
(202) 444-5022
Fax
(202) 444-7987
NPI assigned
Mar 21, 2019
Last updated
Jan 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 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 NU
Surgery Physician 208600000X D92461 MD Primary

Addresses

Primary practice location

3800 Reservoir Rd NW
Washington, DC 20007-2113

Mailing address

5401 Old Court Rd
Randallstown, MD 21133-5103
Phone (410) 521-2200

Other practice location 1

5401 Old Court Rd
Randallstown, MD 21133-5103
Phone (410) 521-2200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20220110002724 MD Practitioner - General Surgery 3870985559 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D92461MDMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Hospital Center, Inc. CurrentSince Jan 17, 2022 Accepting new patients
Northwest Hospital Center, Inc Surgery CurrentSince Jan 17, 2022 Accepting new patients
Northwest Hospital Center, Inc. Past Accepting new patients

Locations

5401 Old Court Rd
Randallstown, MD 21133
Phone (301) 337-2727

Organizations & group practices 3

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": "1553126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1285194621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 OLD COURT RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211335103",
            "telephone_number": "410-521-2200",
            "fax_number": "410-521-7669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 RESERVOIR RD NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200072113",
            "telephone_number": "202-444-5022",
            "fax_number": "202-444-7987"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5401 Old Court Rd",
            "address_purpose": "LOCATION",
            "city": "Randallstown",
            "state": "MD",
            "postal_code": "211335103",
            "country_code": "US",
            "telephone_number": "410-521-2200",
            "fax_number": "410-521-7669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRANNON",
        "first_name": "ARTHUR",
        "middle_name": "L",
        "name_suffix": "III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-21",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MD",
            "license": "D92461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.