Individual provider Active NPI

Michelle Renee Brown, N.P.

  • Nurse Practitioner
  • Macon, GA
National Provider Identifier
1003027434
Registry record updated Oct 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
067038 Issued in GA
Practice address
655 1St St
Macon, GA 31201-2852
Phone
(478) 301-5930
Fax
(478) 301-5932
NPI assigned
May 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 067038 GA Primary

Addresses

Primary practice location

655 1St St
Macon, GA 31201-2852

Mailing address

Mercer Medicine Credentialing
1327 Stadium Drive
Macon, GA 31207-1302
Phone (478) 301-2362

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
067038GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Corporation of Mercer University PastSince Sep 8, 2012 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414540800000",
    "number": "1003027434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MERCER MEDICINE CREDENTIALING",
            "address_2": "1327 STADIUM DRIVE",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312071302",
            "telephone_number": "478-301-2362",
            "fax_number": "478-301-2391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 1ST ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012852",
            "telephone_number": "478-301-5930",
            "fax_number": "478-301-5932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "MICHELLE",
        "middle_name": "RENEE",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-25",
        "last_updated": "2014-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "067038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.