Jeffery T Braham, DO
Individual provider Active NPI Family Medicine Physician · Vienna, WV
NPI 1790788545 · NPPES record last updated Sep 15, 2022
Key facts
- NPI
- 1790788545
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 1492 (WV)
- Practice address
- 800 Grand Central Mall
Suite 4
Vienna, WV 26105-4131 - Phone
- (304) 485-3300
- Fax
- (304) 485-3317
- NPI assigned
- May 24, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- West Virginia School of Osteopathic Medicine, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- United Physicians Care Inc
Practice addresses (Care Compare)
9016 Seneca TRL S
Ronceverte, WV 24970-8375
Phone (681) 318-3477
Hospital & facility affiliations
- Summersville Regional Medical Center
- Camc Greenbrier Valley Medical Center, Inc
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WV
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100513001163 | WV | Practitioner - Family Practice | 5193725398 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34.008763 | OH | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West Virginia School of Osteopathic Medicine Clinic Inc D/B/a Robert C. Byrd Clinic | Family Medicine | Current |
Accepting new patients |
| United Physicians Care Inc | Family Medicine | Current |
Accepting new patients |
| United Physicians Care Inc | Family Medicine | Current |
Accepting new patients |
| Camden Clark Memorial Hospital Corporation | Past | Accepting new patients |
Locations
626 Elk St
Gassaway, WV 26624
Phone (304) 364-2401
1464 Jefferson St N
Lewisburg, WV 24901
Phone (304) 647-5577
800 Garfield Ave
Parkersburg, WV 26101
Phone (304) 420-7161
800 Garfield Ave
Rm G101
Parkersburg, WV 26101
Phone (304) 422-0405
9016 Seneca Trl S
Ronceverte, WV 24970
Phone (304) 647-4968
2373 W Main St
Ste 102
Salem, WV 26426
Phone (304) 782-2000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 34.008763 | OH | |
| Family Medicine Physician | 207Q00000X | 1492 | WV | Yes |
Addresses
Primary practice location
800 Grand Central Mall
Suite 4
Vienna, WV 26105-4131
Mailing address
800 Grand Central Mall
Suite 4
Vienna, WV 26105-4131
Phone (304) 485-3300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0046514000 | Medicaid | WV |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jbraham108839@direct.wvuhsdirect.com | ||
| Direct Messaging Address | jbraham108839@direct.wvuhsdirect.com | ||
| Direct Messaging Address | jbraham108839@direct.wvuhsdirect.com | Health Information Exchange (HIE) | |
| Direct Messaging Address | jbraham108839@direct.wvuhsdirect.com | Health Information Exchange (HIE) | |
| Direct Messaging Address | jbraham108839@direct.wvuhsdirect.com | Health Information Exchange (HIE) | |
| Direct Messaging Address | jbraham108839@direct.wvuhsdirect.com | Health Information Exchange (HIE) |
Other providers in Vienna, WV
- Tamma Borzotra
- Tiffany Boso
- Mattie Bowe
- Angie Bowers
- Halee Janelle Bowie
- Cheryl Leanna Brand
- Carrie Brezinski
- Wesley Britton
- Savanna Brookover
- Curtiss Brooks
All providers in Vienna, WV · Family Medicine Physician in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 15, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.