Michael Bivens Brannan, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

04481R Issued in LA

Practice address

3217 Mabel St
Shreveport, LA 71103-4022

Phone

(318) 631-9121

Fax

(318) 631-9688

NPI assigned

May 24, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Capitol City Family Health Center Incorporated

  • Federally Qualified Health Center (FQHC)
  • Baton Rouge, LA
  • NPI 1265548614
  NPD (past)

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206921600000",
    "number": "1861495822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 38150",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711338150",
            "telephone_number": "318-631-9121",
            "fax_number": "318-631-9688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3217 MABEL ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034022",
            "telephone_number": "318-631-9121",
            "fax_number": "318-631-9688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANNAN",
        "first_name": "MICHAEL",
        "middle_name": "BIVENS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2008-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "LA",
            "license": "04481R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1195839",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kamel Brakta, MD
• Stephen Michael Brandao Jr., NP
• Roy Brandhurst, MD
• Brandon Group International, LLC (Bgi)
• William Brandt, MD
• Annalesha Brannon, B.A., MHS
• Guy Emilio Brannon, M.D.
• Laverne Senora Brantley, LPC
• Sarah Carson Brantley, P.A.
• Tamika Brantley

• Gastroenterology Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Gastroenterology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2008; 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.