Brown Family Practice, LLC
Organization Active NPI Primary Care Clinic/Center · Fort Valley, GA
NPI 1013257633 · NPPES record last updated Mar 22, 2013
Key facts
- NPI
- 1013257633
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- License
- 036348 (GA)
- Legal business name
- BROWN FAMILY PRACTICE, LLC
- Practice address
- 701 Bluebird Blvd
Fort Valley, GA 31030-5085 - Phone
- (478) 827-1971
- Fax
- (478) 827-1973
- NPI assigned
- Feb 19, 2013
- Organization subpart
- No
Authorized official
- Name
- Crystal L Brown, M.D.
- Title
- Physician
- Phone
- (478) 827-1971
Practitioners 2
-
Crystal Lynn Brown, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130321000279 | GA | Part B Supplier - Clinic/Group Practice | 5597900555 |
Receives reassigned benefits from 1 practitioner Practice locations: Fort Valley, GA |
National Provider Directory
Interoperability endpoints
- https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.61037
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | 036348 | GA | Yes |
Addresses
Primary practice location
701 Bluebird Blvd
Fort Valley, GA 31030-5085
Mailing address
701 Bluebird Blvd
Fort Valley, GA 31030-5085
Phone (478) 827-1971
Other providers in Fort Valley, GA
- Danielle Bivens
- Kenneth M Bleicher
- Jennifer Bowens
- Brentwood Nursing LLC
- Amy Diane Brigman
- Crystal Lynn Brown
- O'Mariana Brown
- Tammi L Cantrell
- Careconnect Health, Inc.
- Jacqueline Lee Caskey-James
All providers in Fort Valley, GA · Primary Care Clinic/Center in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 22, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.