Active NPI
Jennifer Maze Brown, MD
- Pediatrics Physician
- Elizabeth City, NC
National Provider Identifier
1073650495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 24173
- Practice address
- 711 Roanoke Ave
Elizabeth City, NC 27909-5643 - Phone
- (252) 338-4400
- NPI assigned
- Feb 1, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 24173 | NC | Primary |
Addresses
Primary practice location
711 Roanoke Ave
Elizabeth City, NC 27909-5643
Mailing address
PO Box 189
Elizabeth City, NC 27907-0189
Phone (252) 338-4400
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 19127 | Other | NC | BLUE CROSS BLUE SHIELD |
| 89-19127 | Medicaid | NC |
Other names 1
- Dr. Jennifer Sue Maze
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24173 | NC | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660003200000",
"number": "1073650495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 189",
"city": "ELIZABETH CITY",
"state": "NC",
"postal_code": "279070189",
"telephone_number": "252-338-4400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "711 ROANOKE AVE",
"city": "ELIZABETH CITY",
"state": "NC",
"postal_code": "279095643",
"telephone_number": "252-338-4400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "JENNIFER",
"middle_name": "MAZE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-01",
"last_updated": "2022-08-09",
"certification_date": "2022-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NC",
"license": "24173",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "19127",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "89-19127",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "MAZE",
"middle_name": "SUE",
"prefix": "DR.",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Elizabeth City, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.