NPIMap

Individual provider Active NPI

Ronald H Brannon, M.D.

  • Anesthesiology Physician
  • Charlotte, NC
National Provider Identifier
1639163124
Registry record updated Feb 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
9501502 Issued in NC
Practice address
200 Providence Rd
Suite 101
Charlotte, NC 28207-1468
Phone
(704) 749-5800
Fax
(704) 749-5819
NPI assigned
Sep 12, 2005
Last updated
Feb 17, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 9501502 NC Primary

Addresses

Primary practice location

200 Providence Rd
Suite 101
Charlotte, NC 28207-1468

Mailing address

200 Providence Rd
Suite 101
Charlotte, NC 28207-1437
Phone (704) 749-5800

Other identifiers 1

IdentifierTypeStateIssuer
8911291MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101028001155 NC Practitioner - Anesthesiology 4587858006 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Baylor College of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Anesthesiology Associates PAGroup PAC ID 3971566761, 218 clinicians

Practice addresses (Care Compare)

10030 Gilead Rd
Suite 120
Huntersville, NC 28078-7545
Phone (704) 316-5670

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Anesthesiology Associates, P.a. Anesthesiology CurrentSince Aug 1, 1983 Accepting new patients

Locations

131 Providence Rd
Ste 200
Charlotte, NC 28207
Phone 70474958001101

1918 Randolph Rd
Ste 740
Charlotte, NC 28207
Phone (704) 316-0810

200 Providence Rd
Ste 101
Charlotte, NC 28207

10030 Gilead Rd
Ste 120
Huntersville, NC 28078
Phone (704) 316-5670

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.

Hospital & facility affiliations 7

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": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329436800000",
    "number": "1639163124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 PROVIDENCE RD",
            "address_2": "SUITE 101",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071437",
            "telephone_number": "704-749-5800",
            "fax_number": "704-749-5819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PROVIDENCE RD",
            "address_2": "SUITE 101",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071468",
            "telephone_number": "704-749-5800",
            "fax_number": "704-749-5819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANNON",
        "first_name": "RONALD",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2012-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "9501502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8911291",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.