Active NPI
Mattie Sullivan Braxton
- Family Nurse Practitioner
- Mount Juliet, TN
National Provider Identifier
1679416572
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 40356
- Practice address
- 216 W Division St
Mount Juliet, TN 37122-3253 - Phone
- (615) 288-3500
- NPI assigned
- Apr 14, 2026
- Last updated
- Apr 14, 2026
- Sex
- Female
- 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 | 40356 | TN | Primary |
Addresses
Primary practice location
216 W Division St
Mount Juliet, TN 37122-3253
Mailing address
900 Easton Dr
Mount Juliet, TN 37122-4475
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40356 | TN | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1776124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776124800000",
"number": "1679416572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 EASTON DR",
"city": "MOUNT JULIET",
"state": "TN",
"postal_code": "371224475"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "216 W DIVISION ST",
"city": "MOUNT JULIET",
"state": "TN",
"postal_code": "371223253",
"telephone_number": "615-288-3500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAXTON",
"first_name": "MATTIE",
"middle_name": "SULLIVAN",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-04-14",
"last_updated": "2026-04-14",
"certification_date": "2026-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TN",
"license": "40356",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Juliet, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.