Individual provider Active NPI

Samuel Braswell

  • Family Nurse Practitioner
  • Dothan, AL
National Provider Identifier
1609280494
Registry record updated Jun 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-131776 Issued in AL
Practice address
201 Doctors Dr
Dothan, AL 36301-2949
Phone
(334) 794-6611
NPI assigned
Jun 19, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-131776 AL Primary

Addresses

Primary practice location

201 Doctors Dr
Dothan, AL 36301-2949

Mailing address

201 Doctors Dr
Dothan, AL 36301-2949
Phone (334) 794-6611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141016000402 AL Practitioner - Nurse Practitioner 1456572460 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Clinic PC 25 clinicians

Practice addresses (Care Compare)

201 Doctors Dr
Dothan, AL 36301-2949
Phone (334) 794-6611

Hospital & facility affiliations

  • Amedisys Home Health Home health agency, Dothan, AL, CCN 017159
  • Enhabit Home Health Home health agency, Dothan, AL, CCN 017053
  • Southeast Health Medical Center Hospital, Dothan, AL, CCN 010001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1-131776ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Clinic PC CurrentSince Jul 18, 2014 Accepting new patients

Locations

201 Doctors Dr
Dothan, AL 36301
Phone (334) 794-6611

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1720
  • Direct secure messaging: jbraswell@scpc.gwaydirect.com

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 and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1403136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404086400000",
    "number": "1609280494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 DOCTORS DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363012949",
            "telephone_number": "334-794-6611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 DOCTORS DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363012949",
            "telephone_number": "334-794-6611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRASWELL",
        "first_name": "SAMUEL",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-19",
        "last_updated": "2014-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-131776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.