NPIMap

Individual provider Active NPI

Blair Brown, MD, MED

  • Preventive Medicine/Occupational Environmental Medicine Physician
  • Missoula, MT
National Provider Identifier
1033596572
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X
License
MED-PHYS-LIC-132614 Issued in MT
Practice address
500 W Broadway St FL 4
Missoula, MT 59802-4008
Phone
(406) 327-1940
Fax
(406) 327-1974
NPI assigned
May 5, 2015
Last updated
Feb 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X PENDING MN
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X 64000 MN
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X MED-PHYS-LIC-132614 MT Primary

Addresses

Primary practice location

500 W Broadway St FL 4
Missoula, MT 59802-4008

Mailing address

PO Box 12
Liberty Lake, WA 99019-0012
Phone (866) 747-2455

Other practice location 1

331 NE Thornton Pl
Seattle, WA 98125-8021
Phone (507) 261-0192

Other practice location 2

200 1st St SW
Rochester, MN 55905
Phone (507) 284-2511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240205001884 MT Practitioner - Preventive Medicine 7911211388 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Preventive Medicine
Education
University of Minnesota Medical School, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services MtGroup PAC ID 6608786306, 358 clinicians

Practice addresses (Care Compare)

500 W Broadway St
FL 4
Missoula, MT 59802-4008
Phone (406) 327-1940

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Master of Education

State licenses

LicenseStateTypeSpecialty
MED-PHYS-LIC-132614MTMDPreventive Medicine/Occupational Environmental Medicine Physician
PENDINGMNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Mt Current Accepting new patients
Providence Health & Services Mt Family Medicine CurrentSince Jan 29, 2024 Accepting new patients
Providence Health & Services Mt CurrentSince Jan 29, 2024 Accepting new patients
Community Nursing Inc. Past Accepting new patients

Locations

500 W Broadway St
Fl 4
Missoula, MT 59802
Phone (406) 327-1900

500 W Broadway St
Ste 320
Missoula, MT 59802

Interoperability endpoints

  • Direct secure messaging: bbrown3191766@wm.providencedirect.org

Organizations & group practices 4

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

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1430784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1033596572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190012",
            "telephone_number": "866-747-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W BROADWAY ST FL 4",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024008",
            "telephone_number": "406-327-1940",
            "fax_number": "406-327-1974"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "331 NE Thornton Pl",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981258021",
            "country_code": "US",
            "telephone_number": "507-261-0192",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 1st St SW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "55905",
            "country_code": "US",
            "telephone_number": "507-284-2511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "BLAIR",
        "credential": "MD, MED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-05",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "PENDING",
            "primary": false
        },
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "MN",
            "license": "64000",
            "primary": false
        },
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "MT",
            "license": "MED-PHYS-LIC-132614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.