Individual provider Active NPI

Jamey L Brannon

  • Mental Health Counselor
  • Dodge City, KS
National Provider Identifier
1366707408
Registry record updated Jul 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
T-LMLP 1435 Issued in KS
Practice address
11200 Lariat Way
Dodge City, KS 67801-7328
Phone
(620) 225-0276
Fax
(620) 225-0279
NPI assigned
Jul 4, 2012
Last updated
Jul 4, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X T-LMLP 1435 KS Primary

Addresses

Primary practice location

11200 Lariat Way
Dodge City, KS 67801-7328

Mailing address

4505 E 47TH St S
Wichita, KS 67210-1651
Phone (316) 529-9100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
T-LMLP 1435KSMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1341360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341360000000",
    "number": "1366707408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4505 E 47TH ST S",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672101651",
            "telephone_number": "316-529-9100",
            "fax_number": "316-529-9351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11200 LARIAT WAY",
            "city": "DODGE CITY",
            "state": "KS",
            "postal_code": "678017328",
            "telephone_number": "620-225-0276",
            "fax_number": "620-225-0279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANNON",
        "first_name": "JAMEY",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-04",
        "last_updated": "2012-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KS",
            "license": "T-LMLP 1435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dodge City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2012; 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.