Individual provider Active NPI

Brianna Joy Cowan, M.D.

  • Internal Medicine Physician
  • Shiprock, NM
National Provider Identifier
1073797684
Registry record updated Aug 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A104666 Issued in CA
Practice address
US Hwy 491 North
Shiprock, NM 87420-0160
Phone
(505) 368-6001
NPI assigned
Dec 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A104666 CA Primary
Pediatrics Physician 208000000X A104666 CA

Addresses

Primary practice location

US Hwy 491 North
Shiprock, NM 87420-0160

Mailing address

PO Box 160
Shiprock, NM 87420-0160
Phone (505) 368-6001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20150121002093 CA Practitioner - Internal MedicinePractitioner - Pediatric Medicine 6507981586 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
University of Wisconsin School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Venice Family Clinic 101 clinicians

Practice addresses (Care Compare)

2509 Pico Blvd
Santa Monica, CA 90405-1828
Phone (310) 664-7901

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A104666CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California CurrentSince Jan 1, 2015 Accepting new patients
UCLA Medical Group Internal Medicine Past Accepting new patients

Locations

200 Medical Plz
Ste 465
Los Angeles, CA 90095
Phone (310) 825-5510

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

File 55737
Los Angeles, CA 90074

2020 Santa Monica Blvd
Ste 210
Santa Monica, CA 90404
Phone (310) 458-2381

Interoperability endpoints

  • Direct secure messaging: bcowan753308@direct.ochin.org

Organizations & group practices 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1198022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282867200000",
    "number": "1073797684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 160",
            "city": "SHIPROCK",
            "state": "NM",
            "postal_code": "874200160",
            "telephone_number": "505-368-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "US HWY 491 NORTH",
            "city": "SHIPROCK",
            "state": "NM",
            "postal_code": "874200160",
            "telephone_number": "505-368-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COWAN",
        "first_name": "BRIANNA",
        "middle_name": "JOY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-19",
        "last_updated": "2010-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A104666",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A104666",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shiprock, NM

Sources for this page

Verify at the official NPI Registry.