Individual provider Active NPI

Braden Douglas Parmer, MD

  • Family Medicine Physician
  • Fort Wayne, IN
National Provider Identifier
1346655339
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
11017886A Issued in IN
Practice address
750 Broadway
Suite 350
Fort Wayne, IN 46802-1411
Phone
(260) 423-2675
Fax
(260) 399-4243
NPI assigned
Jun 27, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 32999 OK
Family Medicine Physician 207Q00000X 11017886A IN Primary

Addresses

Primary practice location

750 Broadway
Suite 350
Fort Wayne, IN 46802-1411

Mailing address

750 Broadway
Suite 150
Fort Wayne, IN 46802-1411
Phone (260) 423-2682

Other practice location 1

3204 Medical Park Dr
Shawnee, OK 74804-5014
Phone (405) 878-6800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170717000364 OK Practitioner - Family Practice 3072731629 Reassigns benefits to 1 organization
I20240509004040 TX Practitioner - Family Practice 3072731629 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Oklahoma College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Citizen Potawatomi NationGroup PAC ID 3375511488, 35 clinicians

Practice addresses (Care Compare)

2307 Gordon Cooper Dr
Shawnee, OK 74801-9007
Phone (405) 273-5236

781 Grand Casino Blvd
Shawnee, OK 74804-1005
Phone (405) 964-4025

Hospital & facility affiliations

  • Centric Home Health Home health agency, Durant, OK, CCN 377791
  • SSM Health St Anthony Hospital - Shawnee Hospital, Shawnee, OK, CCN 370149

Merit-based Incentive Payment System (MIPS)

Final score
84.48 of 100Reported as group
Quality
81.18
Promoting interoperability
93
Improvement activities
40
Cost
72.93

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Citizen Potawatomi Nation CurrentSince Mar 25, 2024 Accepting new patients
Citizen Potawatomi Nation CurrentSince Mar 25, 2024 Accepting new patients
Citizen Potawatomi Nation Current Accepting new patients
SSM Health Care of Oklahoma, Inc Current Accepting new patients
Fort Wayne Medical Education Program Family Medicine PastSince Jul 24, 2022 Accepting new patients

Locations

7106 Solutions Ctr
Chicago, IL 60677

608 NW 9th St
Ste 1100
Oklahoma City, OK 73102
Phone (405) 231-3000

1000 N Lee Ave
Oklahoma City, OK 73102
Phone (405) 272-6152

2307 Gordon Cooper Dr
Shawnee, OK 74801
Phone (405) 273-5236

3315 Kethley Rd
Shawnee, OK 74804
Phone (405) 273-5801

781 Grand Casino Blvd
Shawnee, OK 74804
Phone (405) 964-4025

Interoperability endpoints

  • FHIR API: https://epicproxy.et1447.epichosted.com/APIProxyPRD/api/FHIR/R4

Organizations & group practices 5

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 2

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": "1403827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1346655339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 BROADWAY",
            "address_2": "SUITE 150",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468021411",
            "telephone_number": "260-423-2682",
            "fax_number": "260-422-4326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 BROADWAY",
            "address_2": "SUITE 350",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468021411",
            "telephone_number": "260-423-2675",
            "fax_number": "260-399-4243"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3204 Medical Park Dr",
            "address_purpose": "LOCATION",
            "city": "Shawnee",
            "state": "OK",
            "postal_code": "748045014",
            "country_code": "US",
            "telephone_number": "405-878-6800",
            "fax_number": "405-878-6831",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARMER",
        "first_name": "BRADEN",
        "middle_name": "DOUGLAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-27",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "32999",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "11017886A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.