Braincare, LLC

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

BRAINCARE, LLC

Doing business as

Global Neuro-Diagnostics

Practice address

111 SW 5TH Ave
Ste 3150 (Unit 3142)
Portland, OR 97204-3604

Phone

(866) 848-2522

Fax

(877) 290-1544

NPI assigned

Nov 21, 2016

Organization subpart

No

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

Authorized official

Name

Janice Shock

Title

Sr Director of Operations

Phone

(214) 532-3757

Specialties & licenses 1

Addresses

Other names 1

• Global Neuro-Diagnostics Doing business as

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

{
    "created_epoch": "1479686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479686400000",
    "number": "1366985483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2670 FIREWHEEL DR",
            "address_2": "STE B",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750284601",
            "telephone_number": "866-848-2522",
            "fax_number": "877-290-1544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 SW 5TH AVE",
            "address_2": "STE 3150 (UNIT 3142)",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972043604",
            "telephone_number": "866-848-2522",
            "fax_number": "877-290-1544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAINCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-21",
        "last_updated": "2016-11-21",
        "status": "A",
        "authorized_official_last_name": "SHOCK",
        "authorized_official_first_name": "JANICE",
        "authorized_official_title_or_position": "SR DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "214-532-3757"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Global Neuro-Diagnostics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ashley Nicole Brainard, MA, QMHP
• Joseph Cody Brainard, DPT
• Heather Braman, LMT
• Isabelle Rose Braman, CRM I
• Angela Giovanna Brambila
• Adam Bramble, D.C.
• Maranda Rae Brambora, CRM

• Physiological Laboratory in Portland, OR
• Providers in Portland, OR by specialty
• Physiological Laboratory in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2016; 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.