Loretta Brown, D.O

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS004959L Issued in PA

Practice address

48 Garrrett Road
Successful Aging Care Inc.
Upper Darby, PA 19082

Phone

(267) 701-1791

NPI assigned

Mar 16, 2009

Last updated

Aug 19, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1237161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313712000000",
    "number": "1083855456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 GARRRETT ROAD",
            "address_2": "SUCCESSFUL AGING CARE INC.",
            "city": "UPPER DARBY",
            "state": "PA",
            "postal_code": "19082",
            "telephone_number": "267-701-1791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 GARRRETT ROAD",
            "address_2": "SUCCESSFUL AGING CARE INC.",
            "city": "UPPER DARBY",
            "state": "PA",
            "postal_code": "19082",
            "telephone_number": "267-701-1791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "LORETTA",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-16",
        "last_updated": "2011-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS004959L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00863935",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bright Mind Behavioral LLC
• Jeffrey Alan Brooks, O.D.
• Thomas Michael Broomall, D.C.
• Donovan R Brown, D.C
• Glenn Arthur Brown, DMD
• Tina Alishia Brown
• Stephanie Burke, LSW
• Lindsay P Cabey, D.C.
• Francis James Carbo, DDS
• Care First Home Health Inc

• Family Medicine Physician in Upper Darby, PA
• Providers in Upper Darby, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.