Brandon Keith Vick, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

E12128 Issued in AR

Practice address

612 South 12TH St.
Family Medicine Uams-West
Fort Smith, AR 72901

Phone

(479) 785-2431

Fax

(479) 785-0732

NPI assigned

Mar 23, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

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

Specialty

Family PracticeAlso: Emergency Medicine

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Marys Regional Medical Center Hospital, Russellville, AR, CCN 040041

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: brandon.vick.1@14285.direct.athenahealth.com

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.

• Southeastern Emergency Physicians LLC

  • Emergency Medicine Physician
  • Maysville, KY
  • NPI 1356379382

  AR

  Medicare reassignment Care Compare group NPD
• Arkansas Emergency Staffing Solutions, Inc

  • Emergency Medicine Physician
  • Hope, AR
  • NPI 1275774630
  Medicare reassignment NPD
• Baptist Medcare, Inc

  • Emergency Medicine Physician
  • Little Rock, AR
  • NPI 1699868323
  Medicare reassignment NPD
• General Emergency Physicians, Inc.

  • Emergency Medicine Physician
  • North Little Rock, AR
  • NPI 1386954873
  Medicare reassignment NPD
• Mercy Hospital Booneville

  • Certified Registered Nurse Anesthetist
  • Booneville, AR
  • NPI 1083004733
  Medicare reassignment NPD
• Mercy Hospital Booneville

  • Critical Access Hospital
  • Booneville, AR
  • NPI 1992133714
  Medicare reassignment NPD
• Mercy Hospital Ozark

  • Critical Access Hospital
  • Ozark, AR
  • NPI 1275504128
  Medicare reassignment NPD
• Mercy Hospital Ozark

  • Emergency Care Clinic/Center
  • Ozark, AR
  • NPI 1881642767
  Medicare reassignment NPD
• Mercy Hospital Paris

  • Emergency Care Clinic/Center
  • Paris, AR
  • NPI 1518915321
  Medicare reassignment NPD
• Mercy Hospital Paris

  • Critical Access Hospital
  • Paris, AR
  • NPI 1760453633
  Medicare reassignment NPD
• Mercy Hospital Waldron

  • Emergency Care Clinic/Center
  • Waldron, AR
  • NPI 1730137134
  Medicare reassignment NPD
• Mercy Hospital Waldron

  • Critical Access Hospital
  • Waldron, AR
  • NPI 1912978875
  Medicare reassignment NPD

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

• Russellville Holdings LLC

  • General Acute Care Hospital
  • Russellville, AR
  • NPI 1033160049
  Care Compare affiliation

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

{
    "created_epoch": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563408000000",
    "number": "1972034775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 SOUTH 12TH ST.",
            "address_2": "FAMILY MEDICINE UAMS-WEST",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "72901",
            "telephone_number": "479-785-2431",
            "fax_number": "479-785-0732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 SOUTH 12TH ST.",
            "address_2": "FAMILY MEDICINE UAMS-WEST",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "72901",
            "telephone_number": "479-785-2431",
            "fax_number": "479-785-0732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICK",
        "first_name": "BRANDON",
        "middle_name": "KEITH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-23",
        "last_updated": "2019-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "E12128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vera Whole Health Wa, PC
• Veracity Onsite LLC
• Emily R Vernon, MS, OTR/L
• Rowland P Vernon Jr., MD
• Veterans Health Care System of the Ozarks
• Karina Villanueva
• Reagan Villines, PMHNP
• Bryant Thompson Virden, M.D.
• Vision Group ASC, LLC
• Vision Plus Inc

• Emergency Medicine Physician in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Emergency Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (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.