Individual provider Active NPI

Bethanie Anne Brann, ATC

  • Athletic Trainer
  • Lebanon, NH
National Provider Identifier
1720419070
Registry record updated Dec 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
0562 Issued in NH
Practice address
42 Wolf Rd Unit 523
Lebanon, NH 03766-1935
Phone
(207) 512-0608
NPI assigned
Dec 11, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 0562 NH Primary

Addresses

Primary practice location

42 Wolf Rd Unit 523
Lebanon, NH 03766-1935

Mailing address

42 Wolf Rd Unit 523
Lebanon, NH 03766-1935
Phone (207) 512-0608

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

LicenseStateTypeSpecialty
0562NHMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1386720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386720000000",
    "number": "1720419070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 WOLF RD UNIT 523",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037661935",
            "telephone_number": "207-512-0608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 WOLF RD UNIT 523",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037661935",
            "telephone_number": "207-512-0608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANN",
        "first_name": "BETHANIE",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-11",
        "last_updated": "2013-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NH",
            "license": "0562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.