Individual provider Active NPI

Shellie Ann Branson, DMD

  • Pediatric Dentistry
  • Louisville, KY
National Provider Identifier
1518187251
Registry record updated Sep 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
5779 Issued in KY
Practice address
2015 Herr Lane
Suite D
Louisville, KY 40222
Phone
(502) 426-0088
Fax
(502) 426-7828
NPI assigned
Apr 26, 2007
Last updated
Sep 22, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 5779 KY Primary

Addresses

Primary practice location

2015 Herr Lane
Suite D
Louisville, KY 40222

Mailing address

2015 Herr Lane
Suite D
Louisville, KY 40222
Phone (502) 426-0088

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

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285113600000",
    "number": "1518187251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 HERR LANE",
            "address_2": "SUITE D",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40222",
            "telephone_number": "502-426-0088",
            "fax_number": "502-426-7828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 HERR LANE",
            "address_2": "SUITE D",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40222",
            "telephone_number": "502-426-0088",
            "fax_number": "502-426-7828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANSON",
        "first_name": "SHELLIE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2010-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "KY",
            "license": "5779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2010; 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.