Individual provider Active NPI

Jeffery C Brown, MD

  • Internal Medicine Physician
  • Salem, OR
National Provider Identifier
1073596532
Registry record updated Jan 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD26367 Issued in OR
Practice address
5050 Skyline Village Loop S
Salem, OR 97306-9490
Phone
(503) 391-1110
Fax
(503) 370-4237
NPI assigned
Nov 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD26367 OR Primary

Addresses

Primary practice location

5050 Skyline Village Loop S
Salem, OR 97306-9490

Mailing address

5050 Skyline Village Loop S
Salem, OR 97306-9490
Phone (503) 391-1110

Other identifiers 1

IdentifierTypeStateIssuer
274002MedicaidOR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060224000632 OR Practitioner - Internal Medicine 6800802133 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Kansas School of Med (KC/Wich/Sal), 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salem HealthGroup PAC ID 8628986668, 470 clinicians

Practice addresses (Care Compare)

105 Arney Rd
Suite 120
Woodburn, OR 97071-9472
Phone (503) 814-8640

5050 Skyline Village Loop S
Salem, OR 97306-9490
Phone (503) 391-1110

665 Winter St SE
Salem, OR 97301-3934
Phone (503) 561-5200

Hospital & facility affiliations

  • First Call Home Health Agency, LLC Home health agency, Salem, OR, CCN 387147
  • Mission Home Health of Salem Home health agency, Salem, OR, CCN 387108
  • Salem Health West Valley Hospital, Dallas, OR, CCN 381308
  • Salem Hospital Hospital, Salem, OR, CCN 380051

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions14
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD26367ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Salem Health CurrentSince Jan 1, 2020 Accepting new patients
Salem Health Current Accepting new patients
Salem Health CurrentSince Jan 1, 2020 Accepting new patients

Locations

5100 River Rd N
Keizer, OR 97303
Phone (503) 393-2533

5050 Skyline Village Loop S
Salem, OR 97306
Phone (503) 291-2123

665 Winter St SE
Salem, OR 97301
Phone (503) 370-5634

Interoperability endpoints

  • Direct secure messaging: jbrown19723@direct.salemhealth.org

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326931200000",
    "number": "1073596532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 SKYLINE VILLAGE LOOP S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973069490",
            "telephone_number": "503-391-1110",
            "fax_number": "503-370-4237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 SKYLINE VILLAGE LOOP S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973069490",
            "telephone_number": "503-391-1110",
            "fax_number": "503-370-4237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JEFFERY",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-29",
        "last_updated": "2012-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD26367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274002",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.