Individual provider Active NPI

Christopher Scott Brown, PSY.D., ABPP

  • Clinical Psychologist
  • Fairbanks, AK
National Provider Identifier
1144549924
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSYP663 Issued in AK
Practice address
250 Cushman St Ste 3E
Fairbanks, AK 99701-4665
Phone
(907) 799-7695
Fax
(907) 328-0907
NPI assigned
May 19, 2010
Last updated
Apr 24, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSYP663 AK Primary
Clinical Psychologist 103TC0700X PY60255369 WA

Addresses

Primary practice location

250 Cushman St Ste 3E
Fairbanks, AK 99701-4665

Mailing address

250 Cushman St Ste 3E
Fairbanks, AK 99701-4665
Phone (907) 799-7695

Other identifiers 1

IdentifierTypeStateIssuer
1626763MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Apr 1, 2017 through Apr 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSYP663AKMDClinical Psychologist
PY60255369WAMDClinical Psychologist
663AKMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Arctic Pathways, LLC Clinical CurrentSince Apr 28, 2024 Accepting new patients

Locations

250 Cushman St
Ste 3E
Fairbanks, AK 99701
Phone (907) 479-0411

3180 Peger Rd
Ste 248
Fairbanks, AK 99709
Phone (907) 799-7695

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, 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": "1274227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1144549924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 CUSHMAN ST STE 3E",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014665",
            "telephone_number": "907-799-7695",
            "fax_number": "907-328-0907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 CUSHMAN ST STE 3E",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014665",
            "telephone_number": "907-799-7695",
            "fax_number": "907-328-0907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "CHRISTOPHER",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "PSY.D., ABPP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-19",
        "last_updated": "2024-04-24",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AK",
            "license": "PSYP663",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY60255369",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1626763",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

Verify at the official NPI Registry.