Shane Palmer Braig
Peer Specialist in Del City, OK. Individual provider (NPI-1).
NPI number1336747609
StatusActive
Last updated in NPPESOct 9, 2020
Details
- NPI
- 1336747609
- Entity type
- Individual (NPI-1)
- Name
- Shane Palmer Braig
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Oct 9, 2020
- Certification date
- Oct 9, 2020
- Last updated
- Oct 9, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 175T00000X | Peer Specialist | – | – | Yes |
Practice location
5113 Se 15th St Ste ADel City, OK 73115-3952
Phone 405-600-3252
Mailing address
100 N University DrEdmond, OK 73034-5207
Phone 405-974-3632
Other practice locations
3621 N Kelley Ave
Oklahoma City, OK 73111-4520
Oklahoma City, OK 73111-4520
Phone 405-524-5525
2305 Nw 113th St
Oklahoma City, OK 73120-7302
Oklahoma City, OK 73120-7302
Phone 619-878-0445
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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