Individual provider Active NPI

Patrick Brown, D.D.S.

  • Dentist
  • Fayetteville, NC
National Provider Identifier
1124258215
Registry record updated Apr 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8886 Issued in NC
Practice address
2300 Ramsey St
Fayetteville, NC 28301-3856
Phone
(919) 619-0010
NPI assigned
Jul 23, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 8886 NC Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

2300 Ramsey St
Fayetteville, NC 28301-3856

Mailing address

16 Stuyvesant Cres
Asheville, NC 28803-3138
Phone (919) 619-0010

Other practice location 1

1300 Bridge Barrier Rd
Carolina Beach, NC 28428-3938
Phone (919) 619-0010

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

LicenseStateTypeSpecialty
8886NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Patrick Kelly Brown, DDS, PLLC CurrentSince Apr 23, 2023 Accepting new patients

Locations

1300 Bridge Barrier Rd
Carolina Beach, NC 28428
Phone (910) 458-9401

Organizations & group practices 1

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": "1248307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1124258215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 STUYVESANT CRES",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288033138",
            "telephone_number": "919-619-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 RAMSEY ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283013856",
            "telephone_number": "919-619-0010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 Bridge Barrier Rd",
            "address_purpose": "LOCATION",
            "city": "Carolina Beach",
            "state": "NC",
            "postal_code": "284283938",
            "country_code": "US",
            "telephone_number": "919-619-0010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-23",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "8886",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.