Old Towne Medical LLC
NPI 1013312172ActiveOrganization· Nurse Practitioner, Family· Olive Branch, MS
Nurse Practitioner, Family in Olive Branch, Mississippi, registered in NPPES in October 2014. The authorized official on file is Susan C. Brame, CFNP, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1013312172 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 30, 2014 |
| Last updated in NPPES | Jul 30, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Family Primary | 363LF0000X | R644986 | MS |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MS) |
|---|
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