BRANDON BLAKE TELLER FNP-C
NPI 1285477018
Nurse Practitioner - Family in Vicksburg, MS
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
Specialties & Licenses 2
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
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.
Medicare Billing Reassignment
Medicare enrollment records show Brandon Teller reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Vicksburg, MS 39183
- Reassigned Medicare billing, Mississippi enrollment
- 41 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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, MSPhysician 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.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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.
Which organization bills Medicare for Brandon Teller's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Brandon Teller reassigns Medicare benefits to Vicksburg Clinic LLC (Vicksburg, MS). The 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 Brandon Teller's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Brandon Teller accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee and 3 other insurers list Brandon Teller as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
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 15 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.
# Brandon Blake Teller, FNP-C · NPI 1285477018
Family physician in Vicksburg, Mississippi. Individual provider, active in the CMS NPPES registry since June 18, 2024.
## Identity
- **NPI:** 1285477018 (Entity type: Individual)
- **Enumerated:** June 18, 2024
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** F07250420 (Mississippi)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 2100 US-61 N, Vicksburg, MS 39183-4500
- **Phone:** (601) 415-6161
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Vicksburg Clinic LLC (NPI 1790711158, Vicksburg, MS), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2025
## Record status
- **NPPES last updated:** July 16, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1285477018) · Data from the CMS NPPES public registry.