Kenneth Dale Brann Jr.

Primary specialty

Hearing Instrument SpecialistTaxonomy code 237700000X

License

3118 Issued in IL

Practice address

2060 W Iles Ave
Suite C
Springfield, IL 62704-4191

Phone

(636) 284-4987

NPI assigned

Nov 15, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Heartland Hearing, Inc

  • Hearing Instrument Specialist
  • Springfield, IL
  • NPI 1063964922
  NPD (past) Authorized official

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477440000000",
    "number": "1548504665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2060 W ILES AVE",
            "address_2": "SUITE C",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044191",
            "telephone_number": "636-284-4987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 W ILES AVE",
            "address_2": "SUITE C",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044191",
            "telephone_number": "636-284-4987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANN",
        "first_name": "KENNETH",
        "middle_name": "DALE",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-15",
        "last_updated": "2016-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "IL",
            "license": "3118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS HEARING INSTRUMENT DISPENSER",
            "identifier": "3118",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gregory E Brandt, M.D.
• Lori Lee Brandt, LCSW
• Mary Catherine Brandt, MD
• Brandy Kelley Counseling, PLLC
• Amy Michelle Branham, FNP-BC
• Laurent Brard, MD, PHD
• Break Free Physical Therapy PLLC
• Bradley C. Breneman, LCSW
• Careyana M Brenham, M.D.
• Rebecca Ann Brenneisen, NP

• Hearing Instrument Specialist in Springfield, IL
• Providers in Springfield, IL by specialty
• Hearing Instrument Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2016; 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.