Kori Brannan, PA – Physician Assistant

Key facts

NPI: 1922428820
Entity type: Individual (NPI type 1)
Primary specialty: Physician Assistant 363A00000X
License: PA-1174 (AR)
Practice address: 120 Adcock Rd Ste C
Hot Springs, AR 71913-7958
Phone: (501) 651-4488
Fax: (501) 651-4499
NPI assigned: Apr 18, 2014
Sex: Female
Sole proprietor: Yes

Organizations & group practices 1

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.

John R Pace, MD, PA Neurological Surgery Physician · Hot Springs, AR · NPI 1811436124

Medicare reassignment Care Compare group AR

Hospital & facility affiliations 1

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

Hot Springs National Park Hospital Holdings LLC General Acute Care Hospital · Hot Springs, AR · NPI 1841241833

Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty: Physician Assistant
Education: University of Arkansas College of Medicine, 2022
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Group practices: John R Pace MD PA (3 clinicians)

Practice addresses (Care Compare)

120 Adcock Rd
Suite C
Hot Springs, AR 71913-7958
Phone (501) 651-4488

120 Adcock Rd C
Hot Springs, AR 71913-7958

Hospital & facility affiliations

National Park Medical Center Hospital · Hot Springs, AR · CCN 040078

Medicare participation

Medicare fee-for-service enrollment: Enrolled in AR
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20230703000597	AR	Practitioner - Physician Assistant	7911366380	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Physician Assistant

State licenses

License	State	Type	Specialty
577	AR	MD	Athletic Trainer
PA-1174	AR	MD	Physician Assistant

Interoperability endpoints

Direct secure messaging: kori.brannan.1@16721.direct.athenahealth.com

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Athletic Trainer	2255A2300X	577	AR
Physician Assistant	363A00000X	PA-1174	AR	Yes

Addresses

Primary practice location

120 Adcock Rd Ste C
Hot Springs, AR 71913-7958

Mailing address

300 Prospect Ave
Hot Springs, AR 71901-4003
Phone (501) 622-3334

Other providers in Hot Springs, AR

All providers in Hot Springs, AR · Physician Assistant in Arkansas

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 19, 2023. 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.

Verify at the official NPI Registry.