Jason Gregory Branham, DC, MA

Primary specialty

Health & Wellness CoachTaxonomy code 171400000X

Practice address

2901 Rivers BND S
Bonne Terre, MO 63628-3836

Phone

(901) 351-9703

NPI assigned

Mar 22, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1679443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682208000000",
    "number": "1457054181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 RIVERS BND S",
            "city": "BONNE TERRE",
            "state": "MO",
            "postal_code": "636283836",
            "telephone_number": "901-351-9703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 RIVERS BND S",
            "city": "BONNE TERRE",
            "state": "MO",
            "postal_code": "636283836",
            "telephone_number": "901-351-9703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANHAM",
        "first_name": "JASON",
        "middle_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "DC, MA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-22",
        "last_updated": "2023-04-23",
        "certification_date": "2023-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "XXXXXXXXXXX",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "MO",
            "license": "0000000000000",
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leisa Jan Blue, CFNP
• Bonne Terre Health Clinic LLC
• Bonne Terre Healthcare Clinic LLC
• Bonne Terre Medical Associates, P.C.
• Todd Borron, L.M.T.
• April Brannum, FNP-C
• Phillip A. Brewer, MD
• Mary Chandler, AANP
• Michael Clippard, M.D., FAAP
• Glenda Charlene Counts, FNP

• Health & Wellness Coach in Bonne Terre, MO
• Providers in Bonne Terre, MO by specialty
• Health & Wellness Coach in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2023; 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.