Individual provider Active NPI

Edward Brown, PA - C

  • Physician Assistant
  • Loveland, CO
National Provider Identifier
1124067251
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA170 Issued in KY
Practice address
2500 Rocky Mountain Ave Ste 100
Loveland, CO 80538-9004
Phone
(970) 221-1000
NPI assigned
Jun 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.0004436 CO
Physician Assistant 363A00000X PA170 KY Primary

Addresses

Primary practice location

2500 Rocky Mountain Ave Ste 100
Loveland, CO 80538-9004

Mailing address

PO Box 950248
Louisville, KY 40295-0248
Phone (502) 253-4900

Other practice location 1

3900 Kresge Way
Ste 46
Louisville, KY 40207-4660
Phone (502) 899-3858

Other identifiers 1

IdentifierTypeStateIssuer
95001707MedicaidKY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ebrown11007@direct.nortonhealthcare.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, CO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100727000204 KY Practitioner - Physician Assistant 9234262361 Reassigns benefits to 1 organization
I20180315001922 CO Practitioner - Physician Assistant 9234262361 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

2500 Rocky Mountain Ave
Loveland, CO 80538-9004

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

Hospital & facility affiliations

  • Medical Center of the Rockies Hospital, Loveland, CO, CCN 060119

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA.0004436COMDPhysician Assistant
PA170KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Feb 3, 2018 Accepting new patients
Community Medical Associates, Inc. CurrentSince Oct 1, 2022 Accepting new patients
Community Medical Associates, Inc. CurrentSince Oct 1, 2022 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Feb 3, 2018 Accepting new patients
Saint Joseph Regional Medical Center, Inc. Physician Assistant Past Accepting new patients
Saint Joseph Regional Medical Center, Inc. Past Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

2121 E Harmony Rd
Unit 100
Fort Collins, CO 80528
Phone (970) 663-3107

2500 Rocky Mountain Ave
Ste 360
Loveland, CO 80538
Phone (970) 221-5878

2500 Rocky Mountain Ave
Ste 2200
Loveland, CO 80538
Phone (970) 203-7250

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

2500 Rocky Mountain Ave
Ste 100
Loveland, CO 80538
Phone (970) 624-1800

1373 N State Road 62
Madison, IN 47250
Phone (812) 801-0196

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

4123 Dutchmans Ln
Ste 607
Louisville, KY 40207
Phone (502) 899-6470

Organizations & group practices 7

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 3

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": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1124067251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 950248",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402950248",
            "telephone_number": "502-253-4900",
            "fax_number": "502-489-5750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 ROCKY MOUNTAIN AVE STE 100",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805389004",
            "telephone_number": "970-221-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3900 Kresge Way",
            "address_2": "Ste 46",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402074660",
            "country_code": "US",
            "telephone_number": "502-899-3858",
            "fax_number": "502-899-3878",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "EDWARD",
        "credential": "PA - C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0004436",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95001707",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ebrown11007@direct.nortonhealthcare.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4123 Dutchmans Ln Ste 607",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402074725",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Loveland, CO

Sources for this page

Verify at the official NPI Registry.