Individual provider Active NPI

Erin Olivia Brannan, BS, PTA

  • Physical Medicine & Rehabilitation Physician
  • Roswell, NM
National Provider Identifier
1477072346
Registry record updated Sep 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
A1311 Issued in NM
Practice address
117 E 19TH St
Roswell, NM 88201-5151
Phone
(575) 625-3372
Fax
(575) 625-3303
NPI assigned
Sep 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X A1311 NM Primary

Addresses

Primary practice location

117 E 19TH St
Roswell, NM 88201-5151

Mailing address

1304 N Pennsylvania Ave
Roswell, NM 88201-5051

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)
Not enrolled
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
A1311NMMDPhysical Medicine & Rehabilitation Physician

NPI Registry JSON

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

{
    "created_epoch": "1505174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505174400000",
    "number": "1477072346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 N PENNSYLVANIA AVE",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882015051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 E 19TH ST",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882015151",
            "telephone_number": "575-625-3372",
            "fax_number": "575-625-3303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANNAN",
        "first_name": "ERIN",
        "middle_name": "OLIVIA",
        "credential": "BS, PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-12",
        "last_updated": "2017-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NM",
            "license": "A1311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2017; 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.