Brannon Elizabeth Wiedemann, M.D.

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1542 Tulane Ave
New Orleans, LA 70112-2865

Phone

(504) 568-6004

NPI assigned

Mar 20, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

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://fhir4.healow.com/fhir/r4/GCFJBA

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.

• Administrators of the Tulane Educational Fund

  • Specialist
  • New Orleans, LA
  • NPI 1528014164
  Medicare reassignment NPD
• East Louisiana State Hospital

  • Psychiatric Hospital
  • Jackson, LA
  • NPI 1043206543
  Medicare reassignment NPD
• Administrators of the Tulane Educational Fund

  • Specialist
  • Hattiesburg, MS
  • NPI 1033395298
  NPD
• Tulane University Medical Group

  • General Acute Care Hospital
  • New Orleans, LA
  • NPI 1760872238
  NPD (past)

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

{
    "created_epoch": "1363737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525737600000",
    "number": "1689916462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2028 CAMP ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701305032",
            "telephone_number": "985-630-8838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1542 TULANE AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701122865",
            "telephone_number": "504-568-6004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEDEMANN",
        "first_name": "BRANNON",
        "middle_name": "ELIZABETH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-20",
        "last_updated": "2018-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "LA",
            "license": "MD.207587",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chantal Bich Phuong Wickman, MD
• Terrance Wickman
• Nimmi Nimesha Wickramasuriya, M.D.
• Christian Widdows, M.D.
• Kyle Emily Widmer, M.D.
• Trent Matthew Wiedemann
• Joshua James Wiegmann, PT
• Dustin Wielt, PH.D.
• Jeffrey Grant Wiese, MD
• Angela R. Wiggins, MSW, LCSW-BACS

• Student in an Organized Health Care Education/Training Program in New Orleans, LA
• Providers in New Orleans, LA by specialty
• Student in an Organized Health Care Education/Training Program in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2018; 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.