Individual provider Active NPI

Stephanie Ann Branam, D.O.

  • Rheumatology Physician
  • Holland, MI
National Provider Identifier
1750642831
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
5101020011 Issued in MI
Practice address
844 Washington Ave Ste 1200
Holland, MI 49423-7186
Phone
(616) 393-5336
Fax
(616) 392-2889
NPI assigned
Jun 5, 2012
Last updated
Jan 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5101020011 MI
Rheumatology Physician 207RR0500X 5101020011 MI Primary

Addresses

Primary practice location

844 Washington Ave Ste 1200
Holland, MI 49423-7186

Mailing address

844 Washington Ave Ste 1200
Holland, MI 49423-7186
Phone (616) 393-5336

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20170117000253 MI Practitioner - RheumatologyPractitioner - Internal MedicinePractitioner - Hospitalist 1759601594 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Lincoln Memorial University Medical Department, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Holland Community HospitalGroup PAC ID 0446157291, 174 clinicians

Practice addresses (Care Compare)

577 Michigan Ave
Holland, MI 49423-4911

844 Washington Ave
Holland, MI 49423-7186

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101020011MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Holland Community Hospital Rheumatology CurrentSince Jul 15, 2019 Accepting new patients
Holland Community Hospital Current Accepting new patients
Holland Community Hospital CurrentSince Jul 15, 2019 Accepting new patients
Holland Community Hospital PastSince Oct 1, 2021 Accepting new patients
Holland Community Hospital Past Accepting new patients

Locations

415 Wiley Rd
Ste 102
Douglas, MI 49406
Phone (269) 857-3208

175 S Waverly Rd
Holland, MI 49423
Phone (616) 355-3896

577 Michigan Ave
Ste 101
Holland, MI 49423
Phone (616) 393-2190

577 Michigan Ave
Ste 104
Holland, MI 49423
Phone (616) 355-3984

844 Washington Ave
Holland, MI 49423
Phone (616) 355-3874

844 Washington Ave
Ste 1200
Holland, MI 49423
Phone (616) 393-5336

Interoperability endpoints

  • Direct secure messaging: sbranam449857@direct.hfhs.org
  • Direct secure messaging: stephanie.branam@holland.eclinicaldirectplus.com

Organizations & group practices 6

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1338854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1750642831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "844 WASHINGTON AVE STE 1200",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494237186",
            "telephone_number": "616-393-5336",
            "fax_number": "616-392-2889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "844 WASHINGTON AVE STE 1200",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494237186",
            "telephone_number": "616-393-5336",
            "fax_number": "616-392-2889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANAM",
        "first_name": "STEPHANIE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-05",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101020011",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MI",
            "license": "5101020011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

Verify at the official NPI Registry.