Individual provider Active NPI

Mark E Braun, M.D.

  • Internal Medicine Physician
  • Warwick, RI
National Provider Identifier
1497793285
Registry record updated Feb 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
05764 Issued in RI
Practice address
43 Jefferson Blvd Ste 2
Warwick, RI 02888-1078
Phone
(401) 941-2830
Fax
(401) 941-6886
NPI assigned
Jun 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 05764 RI Primary

Addresses

Primary practice location

43 Jefferson Blvd Ste 2
Warwick, RI 02888-1078

Mailing address

110 Elm St
Providence, RI 02903-4626
Phone (877) 771-7401

Other identifiers 1

IdentifierTypeStateIssuer
9025325MedicaidRI

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
05764RIMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551139200000",
    "number": "1497793285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 ELM ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034626",
            "telephone_number": "877-771-7401",
            "fax_number": "401-784-4902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 JEFFERSON BLVD STE 2",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028881078",
            "telephone_number": "401-941-2830",
            "fax_number": "401-941-6886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAUN",
        "first_name": "MARK",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2019-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "05764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9025325",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2019; 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.