Individual provider Active NPI

Dana Brantley, APN

  • Adult Health Nurse Practitioner
  • Meridian, MS
National Provider Identifier
1649423237
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
903935 Issued in MS
Practice address
5002 Highway 39 N BLDG C
Meridian, MS 39301-1078
Phone
(601) 385-9111
Fax
(662) 328-1507
NPI assigned
Oct 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP127550 TX
Adult Health Nurse Practitioner 363LA2200X 903935 MS Primary

Addresses

Primary practice location

5002 Highway 39 N BLDG C
Meridian, MS 39301-1078

Mailing address

670 Leigh Dr
Columbus, MS 39705-3014
Phone (662) 328-1012

Other identifiers 2

IdentifierTypeStateIssuer
149328OtherMOMO LICENSE NUMBER
364281101MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, MS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090415000679 MO Practitioner - Nurse Practitioner 4880741594 Reassigns benefits to 1 organization
I20200513001452 MS Practitioner - Nurse Practitioner 4880741594 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Medical Group IncGroup PAC ID 6608776299, 565 clinicians

Practice addresses (Care Compare)

12277 De Paul Dr
Suite 500
Bridgeton, MO 63044-2540
Phone (314) 291-8824

Hospital & facility affiliations

  • SSM Health Depaul Hospital St Louis Hospital, Bridgeton, MO, CCN 260104

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
903935MSMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Columbus Orthopaedic Clinic, P.a. CurrentSince Jan 1, 2025 Accepting new patients
The Columbus Orthopaedic Clinic, P.a. CurrentSince Jan 1, 2025 Accepting new patients
SSM Medical Group, Inc. CurrentSince Jul 17, 2025 Accepting new patients
SSM Medical Group Inc. CurrentSince Jul 17, 2025 Accepting new patients
SSM St. Charles Clinic Medical Group, Inc. Past Accepting new patients
SSM Health Care St. Louis Past Accepting new patients
The Columbus Orthopaedic Clinic, P.a. Past Accepting new patients

Locations

12277 De Paul Dr
Ste 500
Bridgeton, MO 63044

1551 Wall St
Ste 310
Saint Charles, MO 63303
Phone (636) 669-2268

1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115

441 N Kirkwood Rd
Saint Louis, MO 63122
Phone (314) 687-2716

670 Leigh Dr
Columbus, MS 39705
Phone (662) 327-4540

5002 Highway 39 N
Bldg C
Meridian, MS 39301
Phone (601) 385-9111

1003 Holland Ave
Ste 104
Philadelphia, MS 39350
Phone (601) 385-9111

1001 Holland Ave
Philadelphia, MS 39350
Phone (601) 663-1200

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 1

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": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1649423237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 LEIGH DR",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397053014",
            "telephone_number": "662-328-1012",
            "fax_number": "662-328-1507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5002 HIGHWAY 39 N BLDG C",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393011078",
            "telephone_number": "601-385-9111",
            "fax_number": "662-328-1507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANTLEY",
        "first_name": "DANA",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-28",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP127550",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MS",
            "license": "903935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MO LICENSE NUMBER",
            "identifier": "149328",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "364281101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

Verify at the official NPI Registry.