Zachary David Brown, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

3946 Ice Way
Fort Wayne, IN 46805-1018

Phone

(636) 290-1136

NPI assigned

Jan 18, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1516233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516233600000",
    "number": "1013425529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2907 CANTERBURY BLVD APT 5",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468353238",
            "telephone_number": "636-290-1136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3946 ICE WAY",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468051018",
            "telephone_number": "636-290-1136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "ZACHARY",
        "middle_name": "DAVID",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-18",
        "last_updated": "2018-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ATHLETIC TRAINING",
            "identifier": "36002937A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephen E Brown, MD
• Sydney J Brown
• Tayler Brown
• Terrell Jermaine Brown, MS, MA, LCAC
• William Logan Brown
• Zachary Scot Brown, PHARMD
• Lorinda M Browning, MD
• Tanda S Brownlee, DT-C
• Anastacia Bruce, LMFT
• Audrey Bruce, OTD

• All providers in Fort Wayne, IN
• Athletic Trainer in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 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.