Individual provider Active NPI

Catherine Brown, PA

  • Surgical Physician Assistant
  • Glastonbury, CT
National Provider Identifier
1124031737
Registry record updated Oct 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
001545 Issued in CT
Practice address
330 Western Blvd
Glastonbury, CT 06033-4383
Phone
(860) 246-2071
Fax
(860) 633-2466
NPI assigned
Aug 14, 2006
Last updated
Oct 2, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 001545 CT
Surgical Physician Assistant 363AS0400X 001545 CT Primary

Addresses

Primary practice location

330 Western Blvd
Glastonbury, CT 06033-4383

Mailing address

330 Western Blvd
Glastonbury, CT 06033-4383
Phone (860) 246-2071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20210517001519 NC Practitioner - Physician Assistant 6709830383 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince May 31, 2021 Accepting new patients
Carolinas Physicians Network Inc CurrentSince May 31, 2021 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince May 31, 2021 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince May 31, 2021 Accepting new patients

Locations

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

14214 Ballantyne Lake Rd
Ste 300
Charlotte, NC 28277
Phone (704) 446-5070

Interoperability endpoints

  • Direct secure messaging: cbrown493614@carolinashealthcaresystem.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380672000000",
    "number": "1124031737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 WESTERN BLVD",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060334383",
            "telephone_number": "860-246-2071",
            "fax_number": "860-633-2466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 WESTERN BLVD",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060334383",
            "telephone_number": "860-246-2071",
            "fax_number": "860-633-2466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "CATHERINE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2013-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "001545",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "001545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glastonbury, CT

Sources for this page

Verify at the official NPI Registry.