OLD TOWNE MEDICAL
NPI 1013312172
Nurse Practitioner - Family in Olive Branch, MS
About Old Towne Medical NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
OLD TOWNE MEDICAL (NPI 1013312172) is a healthcare organization registered as a family in Olive Branch, Mississippi and active in the NPI registry since October 2014. The organization lists Susan C Brame, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Old Towne Medical is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Old Towne Medical, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 3 within 10 miles. They are listed nearest first.
Clinicians, nearest first (4)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Old Towne Medical LLC's NPI number?
The NPI number for Old Towne Medical LLC is 1013312172. It was assigned to this organization in the NPPES registry on October 30, 2014. The provider is doing business as Old Towne Medical.
Where is Old Towne Medical LLC located?
Old Towne Medical LLC is located at 9066 Highland St, Olive Branch, MS 38654. The listed phone number is (662) 890-7717.
What is Old Towne Medical LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Old Towne Medical LLC enrolled in Medicare?
Yes. Old Towne Medical LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Old Towne Medical LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Old Towne Medical LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Old Towne Medical LLC was last updated on July 30, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Old Towne Medical · NPI 1013312172
Family organization in Olive Branch, Mississippi. Organization record, active in the CMS NPPES registry since October 30, 2014.
## Identity
- **NPI:** 1013312172 (Entity type: Organization)
- **Enumerated:** October 30, 2014
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Legal business name:** Old Towne Medical Llc
- **Organization subpart:** No
- **Authorized official:** Susan Brame, OWNER
## Practice location
- **Address:** 9066 HIGHLAND ST, Olive Branch, MS 38654-2307
- **Phone:** (662) 890-7717 · **Fax:** (662) 874-6038
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 4 clinicians (Nurse Practitioner) reassign Medicare billing to this organization (form CMS-855R); 2 practice at this address and 3 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 30, 2019
- **Other identifiers:** Medicaid 03278318 (MS)
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Source: [NPI Profile](https://npiprofile.com/npi/1013312172) · Data from the CMS NPPES public registry.