Individual provider Active NPI

Felish Desha Braxton, RN

  • Addiction (Substance Use Disorder) Counselor
  • Madison, WI
National Provider Identifier
1972087146
Registry record updated Aug 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
229046 Issued in WI
Practice address
210 E Olin Ave
Madison, WI 53713-1434
Phone
(608) 807-1428
Fax
(608) 807-1429
NPI assigned
Sep 24, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 229046-30 WI
Addiction (Substance Use Disorder) Counselor 101YA0400X 229046 WI Primary

Addresses

Primary practice location

210 E Olin Ave
Madison, WI 53713-1434

Mailing address

210 E Olin Ave
Madison, WI 53713-1434
Phone (608) 807-1428

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
229046WIMDAddiction (Substance Use Disorder) Counselor
229046-30WIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1537747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1972087146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 E OLIN AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537131434",
            "telephone_number": "608-807-1428",
            "fax_number": "608-807-1429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E OLIN AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537131434",
            "telephone_number": "608-807-1428",
            "fax_number": "608-807-1429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAXTON",
        "first_name": "FELISH",
        "middle_name": "DESHA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-24",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "229046-30",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "229046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; 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.