Katie Lee Bracken, ATC

Primary specialty

Sports Medicine (Emergency Medicine) PhysicianTaxonomy code 207PS0010X

License

1819 Issued in SC

Practice address

550 Harbor Cove LN
Apt. 4400L
Charleston, SC 29412-3009

Phone

(513) 379-3166

NPI assigned

Sep 14, 2015

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 14, 2015.

{
    "created_epoch": "1442188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442188800000",
    "number": "1922476480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 HARBOR COVE LN",
            "address_2": "APT. 4400L",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294123009",
            "telephone_number": "513-379-3166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 HARBOR COVE LN",
            "address_2": "APT. 4400L",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294123009",
            "telephone_number": "513-379-3166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACKEN",
        "first_name": "KATIE",
        "middle_name": "LEE",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-14",
        "last_updated": "2015-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PS0010X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": "SC",
            "license": "1819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glenda Miley Boyle, RPH
• Colleen Jane Boylston, MD
• Joanna S Brabham, CRNA
• Gretchen L Bracey, PNP
• Jennifer Earle Bracey, MD
• Roberta Theresa Bracken, M.D.
• Margaret Bradbury, RD
• Tyra Chay Bradbury, RD
• Jennifer Michele Braden, MD
• Joseph William Bradham, PSYD

• All providers in Charleston, SC
• Sports Medicine (Emergency Medicine) Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2015; 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.