Jack W Brand Jr., MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

10246 Issued in MS

Practice address

1720A Medical Park Dr
Suite 340
Biloxi, MS 39532-2129

Phone

(228) 392-7429

Fax

(228) 396-3830

NPI assigned

Jun 8, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/25282/brand/1/csg/1/fhir/r4

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.

• Singing River Health System

  • Multi-Specialty Clinic/Center
  • Gautier, MS
  • NPI 1083893937
  Medicare reassignment NPD
• Cardiovascular Health Center PLLC

  • Cardiovascular Disease Physician
  • Pascagoula, MS
  • NPI 1134761786
  Medicare reassignment
• Norwood Clinic Inc

  • Multi-Specialty Clinic/Center
  • Birmingham, AL
  • NPI 1104879741
  NPD (past)

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342656000000",
    "number": "1689678674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720A MEDICAL PARK DR",
            "address_2": "SUITE 340",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395322129",
            "telephone_number": "228-392-7429",
            "fax_number": "228-396-3830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720A MEDICAL PARK DR",
            "address_2": "SUITE 340",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395322129",
            "telephone_number": "228-392-7429",
            "fax_number": "228-396-3830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAND",
        "first_name": "JACK",
        "middle_name": "W",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-08",
        "last_updated": "2012-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AL",
            "license": "11555",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MS",
            "license": "10246",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE",
            "identifier": "C02478",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1194874222",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05025093",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tushonda Fleeton Boyd, LCSW
• Tammy Lorraine Boykin, GNP-BC
• Shalon Bradley, LPC, BC-TMH
• Shelbi Bradley, LPC
• Shelby Lauren Bradley
• Russell Tyler Brant
• Catherine Michelle Brashear, NP-C
• Matthew Scott Brashier, D.O.
• Danielle Braswell
• Gregory Breland, LPN

• Cardiovascular Disease Physician in Biloxi, MS
• Providers in Biloxi, MS by specialty
• Cardiovascular Disease Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.