Individual provider Active NPI

Frank S Brathen, M.D.

  • Family Medicine Physician
  • Montevideo, MN
National Provider Identifier
1467459354
Registry record updated Apr 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
29274 Issued in MN
Practice address
824 N 11TH St
Montevideo, MN 56265-1629
Phone
(320) 269-8877
Fax
(320) 269-8186
NPI assigned
Jul 7, 2005
Last updated
Apr 21, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 29274 MN Primary

Addresses

Primary practice location

824 N 11TH St
Montevideo, MN 56265-1629

Mailing address

824 N 11TH St
Montevideo, MN 56265-1629
Phone (320) 269-8877

Other identifiers 1

IdentifierTypeStateIssuer
627585100MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2927MNMDChiropractor
29274MNMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CCM Health Current Accepting new patients

Locations

824 N 11th St
Montevideo, MN 56265
Phone (320) 269-8877

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.

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303344000000",
    "number": "1467459354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "824 N 11TH ST",
            "city": "MONTEVIDEO",
            "state": "MN",
            "postal_code": "562651629",
            "telephone_number": "320-269-8877",
            "fax_number": "320-269-8186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 N 11TH ST",
            "city": "MONTEVIDEO",
            "state": "MN",
            "postal_code": "562651629",
            "telephone_number": "320-269-8877",
            "fax_number": "320-269-8186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRATHEN",
        "first_name": "FRANK",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2011-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "29274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "627585100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montevideo, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2011; 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.