Carla Brown, FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R886751 Issued in MS

Practice address

102 West Freedom Drive
Liberty, MS 39645-0511

Phone

(601) 657-8091

Fax

(225) 657-1085

NPI assigned

Oct 15, 2010

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22116/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1287100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1013227743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 511",
            "city": "LIBERTY",
            "state": "MS",
            "postal_code": "396450511",
            "telephone_number": "601-657-8091",
            "fax_number": "601-657-1085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 WEST FREEDOM DRIVE",
            "city": "LIBERTY",
            "state": "MS",
            "postal_code": "396450511",
            "telephone_number": "601-657-8091",
            "fax_number": "225-657-1085"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Rawls Dr Ste 1300",
            "address_purpose": "LOCATION",
            "city": "McComb",
            "state": "MS",
            "postal_code": "396482866",
            "country_code": "US",
            "telephone_number": "601-249-3541 x712",
            "fax_number": "601-249-3544",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "CARLA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-15",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP08105",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R886751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Liberty, MS
• Providers in Liberty, MS by specialty
• Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.