Individual provider Active NPI

Beverly A Brown, RN

  • General Practice Registered Nurse
  • Fort Worth, TX
National Provider Identifier
1144832429
Registry record updated Aug 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
942432 Issued in TX
Practice address
401 Shadow Grass Ave
Fort Worth, TX 76120-1637
Phone
(818) 276-7621
NPI assigned
Aug 19, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WG0000X 942432 TX Primary

Addresses

Primary practice location

401 Shadow Grass Ave
Fort Worth, TX 76120-1637

Mailing address

401 Shadow Grass Ave
Fort Worth, TX 76120-1637
Phone (818) 276-7621

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
942432TXMDGeneral Practice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1597795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1144832429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 SHADOW GRASS AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761201637",
            "telephone_number": "818-276-7621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 SHADOW GRASS AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761201637",
            "telephone_number": "818-276-7621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "BEVERLY",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-19",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, General Practice",
            "state": "TX",
            "license": "942432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; 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.