Individual provider Active NPI

Camellia Rae Brown, FNP

  • Family Nurse Practitioner
  • Ogallala, NE
National Provider Identifier
1104699784
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
115183 Issued in NE
Practice address
2601 N Spruce St
Ogallala, NE 69153-2465
Phone
(308) 284-4011
NPI assigned
Nov 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 115183 NE Primary

Addresses

Primary practice location

2601 N Spruce St
Ogallala, NE 69153-2465

Mailing address

2601 N Spruce St
Ogallala, NE 69153-2465
Phone (308) 284-4011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240207000731 NE Practitioner - Nurse Practitioner 4284077207 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ogallala Community Hospital 11 clinicians

Practice addresses (Care Compare)

2601 N Spruce St
Suite a
Ogallala, NE 69153-2465
Phone (308) 284-4011

Hospital & facility affiliations

  • Ogallala Community Hospital Hospital, Ogallala, NE, CCN 281355

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
115183NEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ogallala Community Hospital CurrentSince Feb 4, 2024 Accepting new patients
Banner Health Physicians West LLC CurrentSince Jun 29, 2024 Accepting new patients
Ogallala Community Hospital CurrentSince Feb 4, 2024 Accepting new patients
Banner Health Physicians Colorado LLC Past Accepting new patients

Locations

2601 N Spruce St
#A
Ogallala, NE 69153
Phone (308) 284-4011

2601 N Spruce St
Ogallala, NE 69153
Phone (308) 284-3645

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1104699784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 N SPRUCE ST",
            "city": "OGALLALA",
            "state": "NE",
            "postal_code": "691532465",
            "telephone_number": "308-284-4011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 N SPRUCE ST",
            "city": "OGALLALA",
            "state": "NE",
            "postal_code": "691532465",
            "telephone_number": "308-284-4011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "CAMELLIA",
        "middle_name": "RAE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-06",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "115183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogallala, NE

Sources for this page

Verify at the official NPI Registry.