Active NPI
Doretha Clara Brown-Simpson, ED. D.
- Specialist
- Springfield Gardens, NY
National Provider Identifier
1083153472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 195920021
- Practice address
- 22424 144TH Ave
Springfield Gardens, NY 11413-3501 - Phone
- (917) 854-3290
- Fax
- (718) 341-0005
- NPI assigned
- Feb 17, 2017
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 195920021 | NY | Primary |
Addresses
Primary practice location
22424 144TH Ave
Springfield Gardens, NY 11413-3501
Mailing address
224-24 144 Avenue
Springfield Gardens, NY 11413-3501
Phone (917) 854-3290
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1016 | Medicaid | NY |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 195920021 | NY | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1487289600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487289600000",
"number": "1083153472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "224-24 144 AVENUE",
"city": "SPRINGFIELD GARDENS",
"state": "NY",
"postal_code": "114133501",
"telephone_number": "917-854-3290",
"fax_number": "718-341-0005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22424 144TH AVE",
"city": "SPRINGFIELD GARDENS",
"state": "NY",
"postal_code": "114133501",
"telephone_number": "917-854-3290",
"fax_number": "718-341-0005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN-SIMPSON",
"first_name": "DORETHA",
"middle_name": "CLARA",
"name_prefix": "Dr.",
"credential": "ED. D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-02-17",
"last_updated": "2017-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "195920021",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1016",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield Gardens, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.