Shannon Maura Brauer, PTA

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

09120 Issued in OH

Practice address

5467 Cedar Village Dr
Mason, OH 45040-8693

Phone

(859) 444-0590

NPI assigned

Apr 29, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1619654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1447833215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 W 10TH ST",
            "city": "COVINGTON",
            "state": "KY",
            "postal_code": "410113016",
            "telephone_number": "859-444-0590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5467 CEDAR VILLAGE DR",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450408693",
            "telephone_number": "859-444-0590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAUER",
        "first_name": "SHANNON",
        "middle_name": "MAURA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-29",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OH",
            "license": "09120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Hebron",
            "affiliation": "N",
            "endpointDescription": "url",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "113 W 10th St",
            "city": "Covington",
            "state": "KY",
            "country_code": "US",
            "postal_code": "410113016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Suja M Brane, MD
• Mariah Branham
• Gretchen I. Brannon, PA-C
• Carla Danielle Brant
• Mikayla Brantley
• Dana Breeding, LISW-S, LCSW
• Kimberly M Brickler, RN
• Brightstar Senior Living Operations of Mason, LLC
• Brightview LLC
• Amanda Brinkman, DPT, PT

• Physical Medicine & Rehabilitation Physician in Mason, OH
• Providers in Mason, OH by specialty
• Physical Medicine & Rehabilitation Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; 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.