Individual provider Active NPI

Craig Branum, FNP-C

  • Family Nurse Practitioner
  • Odessa, TX
National Provider Identifier
1396320545
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1031894 Issued in TX
Practice address
500 W 4TH St
Odessa, TX 79761-5001
Phone
(432) 640-4000
NPI assigned
Mar 9, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1031894 TX Primary

Addresses

Primary practice location

500 W 4TH St
Odessa, TX 79761-5001

Mailing address

9305 Sedona Ave
Odessa, TX 79765-2239
Phone (432) 661-8963

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210512001765 TX Practitioner - Nurse Practitioner 1759790652 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
85.33 of 100Reported as group
Quality
74.13
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Basin Emergency Physicians PLLC CurrentSince Aug 1, 2022 Accepting new patients
MCH Professional Care PastSince Jun 1, 2021 Accepting new patients

Locations

387 W Interstate 10
Fort Stockton, TX 79735
Phone (432) 336-2004

500 W 4th St
Odessa, TX 79761
Phone (432) 640-1000

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1615248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1396320545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9305 SEDONA AVE",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797652239",
            "telephone_number": "432-661-8963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W 4TH ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797615001",
            "telephone_number": "432-640-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANUM",
        "first_name": "CRAIG",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-09",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1031894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.