Active NPI
Edward R Brown, PA-C
- Physician Assistant
- Newport, WA
National Provider Identifier
1104916899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA10000066
- Practice address
- 714 W Pine St
Newport, WA 99156-9046 - Phone
- (509) 447-2441
- Fax
- (509) 447-0456
- NPI assigned
- Oct 13, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA10000066 | WA | Primary |
Addresses
Primary practice location
714 W Pine St
Newport, WA 99156-9046
Mailing address
714 W Pine St
Newport, WA 99156-9046
Phone (509) 447-2441
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA10000066 | WA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104916899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "714 W PINE ST",
"city": "NEWPORT",
"state": "WA",
"postal_code": "991569046",
"telephone_number": "509-447-2441",
"fax_number": "509-447-0456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "714 W PINE ST",
"city": "NEWPORT",
"state": "WA",
"postal_code": "991569046",
"telephone_number": "509-447-2441",
"fax_number": "509-447-0456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "EDWARD",
"middle_name": "R",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WA",
"license": "PA10000066",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newport, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.