Individual provider Active NPI

Samuel Floyd Brown, M.D.

  • Obstetrics & Gynecology Physician
  • St Petersburg, FL
National Provider Identifier
1104810605
Registry record updated Jan 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME162462 Issued in FL
Practice address
700 6TH St S FL 2
St Petersburg, FL 33701-4815
Phone
(727) 893-6198
Fax
(727) 893-6978
NPI assigned
Sep 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 18575 MS
Obstetrics & Gynecology Physician 207V00000X ME162462 FL Primary

Addresses

Primary practice location

700 6TH St S FL 2
St Petersburg, FL 33701-4815

Mailing address

700 6TH St S FL 2
St Petersburg, FL 33701-4815
Phone (727) 893-6198

Other practice location 1

1860 Chadwick Dr
Suite 300
Jackson, MS 39204-3463
Phone (601) 376-2999

Other identifiers 2

IdentifierTypeStateIssuer
118145500MedicaidFL
02224073MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20040922000479 MS Practitioner - Obstetrics/Gynecology 1456329911 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME162462FLMDObstetrics & Gynecology Physician
18575MSMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Och Professional Services CurrentSince Jul 12, 2024 Accepting new patients
State of Mississippi-University of Mississippi Medical Center CurrentSince Jul 11, 2024 Accepting new patients
State of Mississippi - University of Mississippi Medical Center Current Accepting new patients
Obhg Mississippi, P.C. Obstetrics & Gynecology CurrentSince Jan 1, 2022 Accepting new patients
Vicksburg Healthcare LLC CurrentSince Aug 2, 2021 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Jul 11, 2024 Accepting new patients
Vicksburg Healthcare LLC CurrentSince Aug 2, 2021 Accepting new patients
River Oaks Hospital LLC Past Accepting new patients
Jackson Hma LLC Past Accepting new patients
South Central Regional Medical Center Past Accepting new patients
Central Ms OBGYN Associates, PLLC Obstetrics & Gynecology PastSince Jul 1, 2004 Accepting new patients

Locations

4500 13th St
Gulfport, MS 39501
Phone (228) 236-3872

1225 N State St
Jackson, MS 39202
Phone (601) 292-4261

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

5903 Ridgewood Rd
Ste 3000
Jackson, MS 39211
Phone (601) 899-3300

5903 Ridgewood Rd
Ste 300
Jackson, MS 39211
Phone (601) 899-3300

400 Hospital Rd
Starkville, MS 39759
Phone (662) 323-4320

2100 Highway 61 N
Vicksburg, MS 39183
Phone (601) 883-5001

Networks

  • LA PPO C-SNP

Interoperability endpoints

  • Direct secure messaging: sbrown@direct.mhg.com

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1104810605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 6TH ST S FL 2",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014815",
            "telephone_number": "727-893-6198",
            "fax_number": "727-893-6978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 6TH ST S FL 2",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014815",
            "telephone_number": "727-893-6198",
            "fax_number": "727-893-6978"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1860 Chadwick Dr",
            "address_2": "SUITE 300",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392043463",
            "country_code": "US",
            "telephone_number": "601-376-2999",
            "fax_number": "601-376-2989",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "SAMUEL",
        "middle_name": "FLOYD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MS",
            "license": "18575",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME162462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118145500",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02224073",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.