Individual provider Active NPI

Brian Scott Payne, M.D.

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Lubbock, TX
National Provider Identifier
1932411998
Registry record updated Jul 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
Q7450 Issued in TX
Practice address
602 Indiana Avenue
Division of Pediatric Emergency Medicine
Lubbock, TX 79415
Phone
(068) 775-9700
NPI assigned
Jul 7, 2010
Last updated
Jul 10, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2013012532 MO
Pediatrics Physician 208000000X Q7450 TX
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X Q7450 TX Primary

Addresses

Primary practice location

602 Indiana Avenue
Division of Pediatric Emergency Medicine
Lubbock, TX 79415

Mailing address

1465 S Grand Blvd
Division of Pediatric Emergency Medicine
Saint Louis, MO 63104-1003
Phone (314) 577-5360

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160706000131 TX Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 8123248317 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q7450TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lubbock County Hospital District CurrentSince Jun 30, 2016 Accepting new patients
Lubbock County Hospital District Past Accepting new patients

Locations

11011 Slide Rd
Lubbock, TX 79424
Phone (806) 743-2584

602 Indiana Ave
Lubbock, TX 79415
Phone (806) 743-2898

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1278460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531180800000",
    "number": "1932411998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1465 S GRAND BLVD",
            "address_2": "DIVISION OF PEDIATRIC EMERGENCY MEDICINE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041003",
            "telephone_number": "314-577-5360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 INDIANA AVENUE",
            "address_2": "DIVISION OF PEDIATRIC EMERGENCY MEDICINE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "79415",
            "telephone_number": "068-775-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "BRIAN",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-07",
        "last_updated": "2018-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2013012532",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "Q7450",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "TX",
            "license": "Q7450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.