NPIMap

Individual provider Active NPI

Ernest Earl Braxton Jr., M.D.

  • Neurological Surgery Physician
  • Edwards, CO
National Provider Identifier
1407080716
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
DR.0058687 Issued in CO
Practice address
1140 Edwards Village Blvd Ste B-105
Edwards, CO 81632-5525
Phone
(970) 569-3240
Fax
(866) 725-4659
NPI assigned
May 14, 2009
Last updated
Apr 10, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X DR.0058687 CO Primary

Addresses

Primary practice location

1140 Edwards Village Blvd Ste B-105
Edwards, CO 81632-5525

Mailing address

2472 Patterson Rd Unit 8
Grand Junction, CO 81505-1100
Phone (970) 241-0202

Other practice location 1

360 Peak One Dr Ste 180
Frisco, CO 80443-5948
Phone (970) 668-3633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.
Opted out of Medicare
Previously, effective Oct 1, 2024 through Oct 1, 2026

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Perelman School of Med at the University of Pennsylvania, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Physical Therapy of West Denver Limited PartnershipGroup PAC ID 6709771157, shared by 5 NPIs, 530 clinicians

Practice addresses (Care Compare)

406 E Grace Ave
Woodland Park, CO 80863-3127
Phone (719) 687-3767

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0058687COMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vail-Summit Orthopaedics PC Neurological Surgery Past Accepting new patients

Organizations & group practices 1

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.

Hospital & facility affiliations 10

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": "1242259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1407080716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2472 PATTERSON RD UNIT 8",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815051100",
            "telephone_number": "970-241-0202",
            "fax_number": "970-245-0250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 EDWARDS VILLAGE BLVD STE B-105",
            "city": "EDWARDS",
            "state": "CO",
            "postal_code": "816325525",
            "telephone_number": "970-569-3240",
            "fax_number": "866-725-4659"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "360 Peak One Dr Ste 180",
            "address_purpose": "LOCATION",
            "city": "Frisco",
            "state": "CO",
            "postal_code": "804435948",
            "country_code": "US",
            "telephone_number": "970-668-3633",
            "fax_number": "970-668-4406",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRAXTON",
        "first_name": "ERNEST",
        "middle_name": "EARL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-14",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CO",
            "license": "DR.0058687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edwards, CO

Sources for this page

Verify at the official NPI Registry.