Active NPI
Paul Thomas Brown, RD, LD
- Registered Dietitian
- Fayetteville, AR
National Provider Identifier
1114428984
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86058528
- Practice address
- 3082 W Jewell Rd Apt 1
Fayetteville, AR 72701-1586 - Phone
- (501) 350-1066
- NPI assigned
- Feb 26, 2018
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86058528 | AR | Primary |
Addresses
Primary practice location
3082 W Jewell Rd Apt 1
Fayetteville, AR 72701-1586
Mailing address
3082 W Jewell Rd Apt 1
Fayetteville, AR 72701-1586
Phone (501) 350-1066
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86058528 | AR | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519603200000",
"number": "1114428984",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3082 W JEWELL RD APT 1",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727011586",
"telephone_number": "501-350-1066"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3082 W JEWELL RD APT 1",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727011586",
"telephone_number": "501-350-1066"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "PAUL",
"middle_name": "THOMAS",
"credential": "RD, LD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-02-26",
"last_updated": "2018-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "AR",
"license": "86058528",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.