Active NPI
Jennifer Brown, D.O.
- Psychiatry Physician
- Corvallis, OR
National Provider Identifier
1083900427
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- PG154643
- Practice address
- 3600 NW Samaritan Dr
Corvallis, OR 97330-3737 - Phone
- (541) 768-4906
- NPI assigned
- Jun 23, 2011
- Last updated
- Jul 6, 2015
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | PG154643 | OR | Primary |
Addresses
Primary practice location
3600 NW Samaritan Dr
Corvallis, OR 97330-3737
Mailing address
975Nwspruce Ave 102
Corvallis, OR 97330-2297
Phone (541) 738-8727
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 16, 2023 through Feb 16, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PG154643 | OR | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Catalyst Psychiatry, LLC | Psychiatry | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Psychiatry Physician
- Corvallis, OR
- NPI 1942968672
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436140800000",
"number": "1083900427",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "975NWSPRUCE AVE 102",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973302297",
"telephone_number": "541-738-8727",
"fax_number": "541-758-4503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3600 NW SAMARITAN DR",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973303737",
"telephone_number": "541-768-4906"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "JENNIFER",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-23",
"last_updated": "2015-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "OR",
"license": "PG154643",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corvallis, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.