Individual provider Active NPI

Charles Brown, NP

  • Neonatal Nurse Practitioner
  • Rome, GA
National Provider Identifier
1003207028
Registry record updated Feb 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
RN190606 Issued in GA
Practice address
304 Turner McCall Blvd SW
Rome, GA 30165-5621
Phone
(706) 509-6515
NPI assigned
Feb 12, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X RN190606 GA Primary

Addresses

Primary practice location

304 Turner McCall Blvd SW
Rome, GA 30165-5621

Mailing address

420 E 2ND Ave
Suite 103
Rome, GA 30161-3209
Phone (706) 509-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150507001746 GA Practitioner - Nurse Practitioner 6103145453 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Floyd Physicians, LLC CurrentSince Mar 20, 2015 Accepting new patients

Locations

304 Turner McCall Blvd SW
Rome, GA 30165
Phone (706) 506-5000

420 E 2nd Ave
Ste 103
Rome, GA 30161
Phone (706) 509-3278

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": "1423699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423699200000",
    "number": "1003207028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E 2ND AVE",
            "address_2": "SUITE 103",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301613209",
            "telephone_number": "706-509-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 TURNER MCCALL BLVD SW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301655621",
            "telephone_number": "706-509-6515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "CHARLES",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-12",
        "last_updated": "2015-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "GA",
            "license": "RN190606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

Verify at the official NPI Registry.