Shane Palmer Braig

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

5113 SE 15TH St Ste a
Del City, OK 73115-3952

Phone

(405) 600-3252

NPI assigned

Oct 9, 2020

Last updated

Oct 9, 2020By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Care for Change Inc

  • Addiction (Substance Use Disorder) Counselor
  • Oklahoma City, OK
  • NPI 1265727416
  NPD (past)

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

{
    "created_epoch": "1602201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1336747609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N UNIVERSITY DR",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730345207",
            "telephone_number": "405-974-3632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5113 SE 15TH ST STE A",
            "city": "DEL CITY",
            "state": "OK",
            "postal_code": "731153952",
            "telephone_number": "405-600-3252"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3621 N Kelley Ave",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731114520",
            "country_code": "US",
            "telephone_number": "405-524-5525",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2305 NW 113th St",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731207302",
            "country_code": "US",
            "telephone_number": "619-878-0445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRAIG",
        "first_name": "SHANE",
        "middle_name": "PALMER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-09",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pashen Lecrest Bennett, LPN
• Thomas Dean Blue
• Matthew J Boeckman, MD
• Breanna Eviemarie Boor, DDS
• Mackenzie Alexis Boyle
• Melanie Elaine Broadway
• Jacob C. Brown, PA-C
• Trendolyn Brown
• Carl Bryant
• Carmen Delores Butler

• Peer Specialist in Del City, OK
• Providers in Del City, OK by specialty
• Peer Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.