NPIMap

Individual provider Active NPI

William Martin Bracken, DO

  • Family Medicine Physician
  • De Kalb, MS
National Provider Identifier
1417969031
Registry record updated Nov 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
15288 Issued in MS
Practice address
14365 Highway 16 W
De Kalb, MS 39328-7974
Phone
(601) 743-4626
Fax
(601) 743-2133
NPI assigned
Aug 12, 2006
Last updated
Nov 9, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 15288 MS
Family Medicine Physician 207Q00000X 15288 MS Primary

Addresses

Primary practice location

14365 Highway 16 W
De Kalb, MS 39328-7974

Mailing address

1314 19TH Ave
Meridian, MS 39301-4116
Phone (601) 703-4282

Other identifiers 1

IdentifierTypeStateIssuer
00118406MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040126000182 MS Practitioner - Emergency Medicine 5799687166 Reassigns benefits to 10 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Nova Southeastern College of Osteo Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bonita Emergency Group LLCGroup PAC ID 3870933278, 26 clinicians
Medical Foundation IncGroup PAC ID 9234043712, 211 clinicians
Kemper Cah, Inc.Group PAC ID 5991985012, shared by 7 NPIs, 28 clinicians

Practice addresses (Care Compare)

1314 19TH Ave
Meridian, MS 39301-4116
Phone (601) 483-0011

14365 Hwy 16 W
De Kalb, MS 39328-7974
Phone (769) 486-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.18 of 100Reported as group
Quality
78.43
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
90.17 of 100Reported as group
Quality
86.99
Improvement activities
40
Cost
66.19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15288MSMDEmergency Medicine Physician
13818MSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scott Regional Medical Center, Inc. CurrentSince Jan 1, 2026 Accepting new patients
Rush Medical Foundation Family Medicine CurrentSince Jul 1, 2019 Accepting new patients
Kemper Cah, Inc CurrentSince Aug 1, 2013 Accepting new patients
Kemper Cah, Inc. Emergency Medicine Current Accepting new patients
Laird Hospital, Inc. CurrentSince Jul 1, 2019 Accepting new patients
Rush Medical Foundation Family Medicine Current Accepting new patients
Scott Regional Medical Center, Inc Emergency Medicine Current Accepting new patients
Kemper Cah, Inc. CurrentSince Jan 1, 2026 Accepting new patients
Laird Hospital, Inc. Emergency Medicine CurrentSince Jul 1, 2019 Accepting new patients
Rush Medical Foundation CurrentSince Jul 1, 2019 Accepting new patients
Bonita Emergency Group, LLC Emergency Medicine CurrentSince May 13, 2024 Accepting new patients
Paragon Contracting Services LLC Emergency Medicine Past Accepting new patients
Batesville Emergency Physicians Past Accepting new patients
Delta Health System Past Accepting new patients
McLemore Emergency Physicians Emergency Medicine PastSince Dec 18, 2007 Accepting new patients
Meridian Hma LLC Past Accepting new patients
Delta Physician Practices Past Accepting new patients
Delta Medical Group Emergency Medicine Past Accepting new patients
Montfort Jones Memorial Hospital Past Accepting new patients

Locations

9097 Collinsville Rd
Collinsville, MS 39325
Phone (601) 626-8874

14365 Highway 16 W
De Kalb, MS 39328
Phone (769) 486-1000

1314 19th Ave
Meridian, MS 39301
Phone (601) 483-0011

317 Highway 13 S
Morton, MS 39117
Phone (601) 732-6301

603 S Archusa Ave
Quitman, MS 39355
Phone (601) 776-2123

605 S Archusa Ave
Quitman, MS 39355
Phone (601) 776-6925

25117 Highway 15
Union, MS 39365
Phone (601) 774-8214

Organizations & group practices 20

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.

View all 20

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": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383955200000",
    "number": "1417969031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 19TH AVE",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014116",
            "telephone_number": "601-703-4282",
            "fax_number": "601-703-4597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14365 HIGHWAY 16 W",
            "city": "DE KALB",
            "state": "MS",
            "postal_code": "393287974",
            "telephone_number": "601-743-4626",
            "fax_number": "601-743-2133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACKEN",
        "first_name": "WILLIAM",
        "middle_name": "MARTIN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2013-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "15288",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "15288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00118406",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in De Kalb, MS

Sources for this page

Verify at the official NPI Registry.