Brent Davis Staton, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

45555 Issued in TN

Practice address

1135 S Walnut Ave
Cookeville, TN 38501-5961

Phone

(931) 400-0808

Fax

(615) 735-0008

NPI assigned

Apr 7, 2007

Last updated

Apr 6, 2017By the provider in NPPES

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

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Staton Southern Medical, PLLC

  • Family Medicine Physician
  • Carthage, TN
  • NPI 1295033595
  Medicare reassignment NPD Authorized official
• Smith County Family Medical LLC

  • Family Nurse Practitioner
  • Gordonsville, TN
  • NPI 1053867184
  NPD

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

{
    "created_epoch": "1175904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491436800000",
    "number": "1508989450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 S WALNUT AVE",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385015961",
            "telephone_number": "931-400-0808",
            "fax_number": "931-400-0809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 S WALNUT AVE",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385015961",
            "telephone_number": "931-400-0808",
            "fax_number": "615-735-0008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATON",
        "first_name": "BRENT",
        "middle_name": "DAVIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-07",
        "last_updated": "2017-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "45555",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TN",
            "license": "45555",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TN",
            "license": "45555",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George Allen Starkweather, M.D.
• Vickie Harris Startup, LCSW
• State of Tennessee (Upper Cumberland Regional Clinic)
• State of Tennessee (Putnam County Health Department)
• State of Tennessee (Upper Cumberland Regional Clinic Distributor Pharmacy)
• Caitlin Staton, LPC-MHSP
• Lori Lee Staton
• Gail W Stearman, FNP
• Tonya Katherine Stearns, LPC-MHSP
• Edith Ruchelle Steele, CNS

• Family Medicine Physician in Cookeville, TN
• Providers in Cookeville, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.