Active NPI
Mark E Braun, M.D.
- Internal Medicine Physician
- Warwick, RI
National Provider Identifier
1497793285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 05764
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9025325 | Medicaid | RI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 05764 | RI | MD | Internal 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.