Brannon Myrick

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

10273 Issued in SC

Practice address

2500 N. State St
Department of Oral-Maxillofacial Surgery and Pathology
Jackson, MS 39216-4505

Phone

(601) 984-6090

NPI assigned

Apr 22, 2016

Last updated

Oct 2, 2023By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jun 16, 2022 through Jun 16, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Ccofs Oral Surgery 2 LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Greenville, SC
  • NPI 1700491685
  NPD (past)
• Ccofs Oral Surgery I, LLC

  dba Carolinas Center for Oral & Facial Surgery

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Greenville, SC
  • NPI 1396397501
  NPD (past)
• DRS Farrell, Farrell, Nale, Cook, Kapitan, Mohamed, Franco, Wessel, Ho

  dba Carolinas Center For Oral And Facial Surgery

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Rock Hill, SC
  • NPI 1861913022
  NPD (past)
• DRS Farrell, Farrell, Nale, Cook, Kapitan, Mohamed, Franco, Wessel, Ho

  dba Carolinas Center For Oral And Facial Surgery

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Charlotte, NC
  • NPI 1972554186

  Oral and Maxillofacial Surgery

  NPD (past)

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

{
    "created_epoch": "1461283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1700230083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N. STATE ST",
            "address_2": "DEPARTMENT OF ORAL-MAXILLOFACIAL SURGERY AND PATHOLOGY",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N. STATE ST",
            "address_2": "DEPARTMENT OF ORAL-MAXILLOFACIAL SURGERY AND PATHOLOGY",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164505",
            "telephone_number": "601-984-6090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYRICK",
        "first_name": "BRANNON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-22",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "SC",
            "license": "10273",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mitchell Jeffrey Myers, M.D.
• Natalie Busbee Myers, CCC-SLP
• Olivia Myers
• Shannon J. Myers, MD
• Teresa Myhlhousen, LPC
• Zachary Douglas Myrick
• Harley Nabors
• Linda Naef, TH.D., LCSW
• Robert William Naef III, M.D.
• Laura Nail, NP

• Oral and Maxillofacial Surgery (Dentist) in Jackson, MS
• Providers in Jackson, MS by specialty
• Oral and Maxillofacial Surgery (Dentist) in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.