Individual provider Active NPI

Richard Dix Bratton Jr., D.O.

  • General Practice Physician
  • Gladwin, MI
National Provider Identifier
1528175262
Registry record updated Jan 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
5101007782 Issued in MI
Practice address
1277 E Cedar Ave
Gladwin, MI 48624-7004
Phone
(989) 426-3689
Fax
(989) 426-3694
NPI assigned
Aug 25, 2006
Last updated
Jan 30, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 5101007782 MI Primary

Addresses

Primary practice location

1277 E Cedar Ave
Gladwin, MI 48624-7004

Mailing address

1277 E Cedar Ave
P.O. Box 685
Gladwin, MI 48624-7004
Phone (989) 426-3689

Other identifiers 2

IdentifierTypeStateIssuer
0152616155OtherMIBLUE CLOSS & BLUE SHIELD
114726246MedicaidMI

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 Osteopathy

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391040000000",
    "number": "1528175262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1277 E CEDAR AVE",
            "address_2": "P.O. BOX 685",
            "city": "GLADWIN",
            "state": "MI",
            "postal_code": "486247004",
            "telephone_number": "989-426-3689",
            "fax_number": "989-426-3694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1277 E CEDAR AVE",
            "city": "GLADWIN",
            "state": "MI",
            "postal_code": "486247004",
            "telephone_number": "989-426-3689",
            "fax_number": "989-426-3694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRATTON",
        "first_name": "RICHARD",
        "middle_name": "DIX",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2014-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "5101007782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CLOSS & BLUE SHIELD",
            "identifier": "0152616155",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114726246",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gladwin, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2014; 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.