NPIMap

Individual provider Active NPI

Braxton Lane Nottingham, MD

  • Family Medicine Physician
  • Edmond, OK
National Provider Identifier
1821528480
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
32946 Issued in OK
Practice address
2557 Old Timbers Dr
Edmond, OK 73034-9813
Phone
(405) 669-2600
Fax
(405) 500-1232
NPI assigned
Jun 15, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 32946 OK Primary

Addresses

Primary practice location

2557 Old Timbers Dr
Edmond, OK 73034-9813

Mailing address

3001 Quail Springs Pkwy FL 5
Oklahoma City, OK 73134-2640
Phone (405) 669-2600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181117000269 OK Practitioner - Family Practice 2668745399 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Oklahoma College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Great Plains Medical FoundationGroup PAC ID 9335188184, 12 clinicians
Integris Ambulatory Care CorporationGroup PAC ID 2365408465, 687 clinicians

Practice addresses (Care Compare)

3625 NW 56TH St
Suite 200
Oklahoma City, OK 73112-4509
Phone (405) 951-2855

5720 W Memorial Rd
Oklahoma City, OK 73142-2010
Phone (405) 470-7100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32946OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Great Plains Medical Foundation Family Medicine CurrentSince Feb 20, 2023 Accepting new patients
Integris Ambulatory Care Corporation Family Medicine CurrentSince Jul 20, 2020 Accepting new patients
Integris Health Edmond, Inc Past Accepting new patients
Integris Ambulatory Care C Orporation Family Medicine Past Accepting new patients
Integris Baptist Medical Center Inc Past Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

2557 Old Timbers Dr
Edmond, OK 73034
Phone (405) 669-2600

5720 W Memorial Rd
Oklahoma City, OK 73142
Phone (405) 470-2207

5300 N Independence Ave
Ste 280
Oklahoma City, OK 73112
Phone (405) 552-0155

3001 Quail Springs Pkwy
Fl 5
Oklahoma City, OK 73134

5501 N Portland Ave
Oklahoma City, OK 73112
Phone (405) 604-6000

3400 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 945-4589

3500 NW 56th St
Ste 100
Oklahoma City, OK 73112
Phone (405) 951-2855

3300 NW Expressway St
Oklahoma City, OK 73112
Phone (405) 251-2815

3625 NW 56th St
Ste 200
Oklahoma City, OK 73112
Phone (405) 951-2855

Interoperability endpoints

  • Direct secure messaging: bnottingham78402@direct.integrisok.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 and National Provider Directory roles.

Hospital & facility affiliations 9

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": "1497484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1821528480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 QUAIL SPRINGS PKWY FL 5",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731342640",
            "telephone_number": "405-669-2600",
            "fax_number": "405-500-1232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2557 OLD TIMBERS DR",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730349813",
            "telephone_number": "405-669-2600",
            "fax_number": "405-500-1232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOTTINGHAM",
        "first_name": "BRAXTON",
        "middle_name": "LANE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-15",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "32946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.