Individual provider Active NPI

Braxter P Irby Jr., MD

  • Nephrology Physician
  • Brookhaven, MS
National Provider Identifier
1801877139
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
06205 Issued in MS
Practice address
513C Brookman Dr
Brookhaven, MS 39601-2326
Phone
(601) 833-3822
Fax
(601) 835-4330
NPI assigned
Nov 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 06205 MS Primary

Addresses

Primary practice location

513C Brookman Dr
Brookhaven, MS 39601-2326

Mailing address

513C Brookman Dr
Brookhaven, MS 39601-2326
Phone (601) 833-3822

Other identifiers 1

IdentifierTypeStateIssuer
00115941MedicaidMS

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0625MSMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1801877139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513C BROOKMAN DR",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396012326",
            "telephone_number": "601-833-3822",
            "fax_number": "601-835-4330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513C BROOKMAN DR",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396012326",
            "telephone_number": "601-833-3822",
            "fax_number": "601-835-4330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRBY",
        "first_name": "BRAXTER",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MS",
            "license": "06205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00115941",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookhaven, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.