BRANDON BLAKE TELLER FNP-C
NPI 1285477018
Nurse Practitioner - Family in Vicksburg, MS

Active since June 18, 2024PECOS EnrolledAccepts Medicare Assignment
2100 US-61 N, VICKSBURG, MS 39183(601) 415-6161 Get Directions Write a Review

NPPES record last updated: July 16, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Brandon Blake Teller Fnp-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRANDON BLAKE TELLER FNP-C (NPI 1285477018) is an individual family provider in Vicksburg, Mississippi, licensed in Mississippi (F07250420) and active in the NPI registry since June 2024. He is enrolled in Medicare PECOS, is affiliated with Merit Health River Region, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1285477018
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameBRANDON BLAKE TELLERCredential: FNP-C
Location Address2100 US-61 NVicksburg, MS 39183-4500
Mailing Address2100 Us-61nVicksburg, MS 39183-6094 · (601) 415-6161
Sole ProprietorYes
Medical School CMSOtherGraduated 2025
Enumeration DateJune 18, 2024
Last NPPES UpdateJuly 16, 2025
NPPES CertifiedJuly 16, 2025
NPI 1285477018 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License Licensed in MS · F07250420
Also ListedRegistered Nurse · Critical Care MedicineTaxonomy 163WC0200X · License 918907 (MS)
2100 US-61 N, Vicksburg, MS 39183

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Brandon Blake Teller Fnp-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4880199280
PECOS Enrollment IDI20250925004715
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Merit Health River Region

Acute Care Hospitals · Vicksburg, MS
2/5 CMS rating
OwnershipProprietary
CMS Certification Number250031
Location2100 Hwy 61 NVicksburg, MS 39183 · Warren County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39183 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$80.50 typical visit price
range $51.65 – $159.18
Typical copayment $20.12 (range $12.91 – $39.79)
Most-billed visit code 99203
Established Patient
$92.20 typical visit price
range $16.15 – $129.61
Typical copayment $23.05 (range $4.03 – $32.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Pediatrics
2100 US-61 N
VICKSBURG, MS 39183

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 Brandon Teller's NPI number?

The NPI number for Brandon Teller is 1285477018. It was assigned to this individual provider in the NPPES registry on June 18, 2024.

Where is Brandon Teller located?

Brandon Teller practices at 2100 Us-61 N, Vicksburg, MS 39183. The listed phone number is (601) 415-6161.

What is Brandon Teller's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Brandon Teller enrolled in Medicare?

Yes. Brandon Teller is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Brandon Teller affiliated with any hospitals?

According to CMS data, Brandon Teller is affiliated with Merit Health River Region.

When was this NPI record last updated?

The NPPES record for Brandon Teller was last updated on July 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.