Active NPI
Samuel Braswell
- Family Nurse Practitioner
- Dothan, AL
National Provider Identifier
1609280494
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 1-131776
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
Practice addresses (Care Compare)
201 Doctors Dr
Dothan, AL 36301-2949
Phone (334) 794-6611
Hospital & facility affiliations
- Amedisys Home Health
- Enhabit Home Health
- Southeast Health Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-131776 | AL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern Clinic PC | Current | Accepting new patients |
Locations
201 Doctors Dr
Dothan, AL 36301
Phone (334) 794-6611
Interoperability endpoints
- https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1720
- 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.
-
- Home Health Agency
- Dothan, AL
- NPI 1871503532
-
- Home Health Agency
- Dothan, AL
- NPI 1770561268
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2014; 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.