Individual provider Active NPI

Kathryn Marie Brown, PA-C

  • Physician Assistant
  • Leslie, MI
National Provider Identifier
1154911675
Registry record updated Jun 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601010382 Issued in MI
Practice address
130 N Sherman St
Leslie, MI 49251-9409
Phone
(517) 205-2500
NPI assigned
Jan 19, 2021
Last updated
Jun 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MI
Physician Assistant 363A00000X 109264 IA
Medical Physician Assistant 363AM0700X 109264 IA
Surgical Physician Assistant 363AS0400X 109264 IA
Physician Assistant 363A00000X 5601010382 MI Primary

Addresses

Primary practice location

130 N Sherman St
Leslie, MI 49251-9409

Mailing address

2430 Merrill St
Ypsilanti, MI 48197-4347
Phone (419) 345-3922

Other practice location 1

920 E 2nd Ave
Coralville, IA 52241-2219
Phone (319) 467-2000

Other practice location 2

3056 River Crossing Ct
Riverside, IA 52327-4733
Phone (319) 467-8355

Other practice location 3

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-1616

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20220608002487 MI Practitioner - Physician Assistant 1153728274 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

205 N E Ave
Jackson, MI 49201-1753

7845 Spring Arbor Rd
Spring Arbor, MI 49283-9785
Phone (517) 205-2580

813 W Michigan Ave
Henry Ford Allegiance Osteoporosis Center
Jackson, MI 49202-4158
Phone (517) 205-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601010382MIMDPhysician Assistant
109264IAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
W.a. Foote Memorial Hospital, Inc CurrentSince Jun 1, 2022 Accepting new patients
W.a. Foote Memorial Hospital, Inc Physician Assistant CurrentSince Jun 1, 2022 Accepting new patients
Wa Foote Memorial Hospital, Inc Physician Assistant Past Accepting new patients

Locations

1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892

3333 Spring Arbor Rd
Ste 100
Jackson, MI 49203
Phone (517) 205-2156

813 W Michigan Ave
Jackson, MI 49202
Phone (517) 205-1000

130 N Sherman St
Leslie, MI 49251
Phone (517) 205-2500

7845 Spring Arbor Rd
Spring Arbor, MI 49283
Phone (517) 205-2580

Interoperability endpoints

  • Direct secure messaging: kbrown812598@direct.hfhs.org

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1611014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1154911675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2430 MERRILL ST",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481974347",
            "telephone_number": "419-345-3922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 N SHERMAN ST",
            "city": "LESLIE",
            "state": "MI",
            "postal_code": "492519409",
            "telephone_number": "517-205-2500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "920 E 2nd Ave",
            "address_purpose": "LOCATION",
            "city": "Coralville",
            "state": "IA",
            "postal_code": "522412219",
            "country_code": "US",
            "telephone_number": "319-467-2000",
            "fax_number": "319-467-2410",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3056 River Crossing Ct",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "IA",
            "postal_code": "523274733",
            "country_code": "US",
            "telephone_number": "319-467-8355",
            "fax_number": "319-467-8351",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Hawkins Dr",
            "address_purpose": "LOCATION",
            "city": "Iowa City",
            "state": "IA",
            "postal_code": "522421009",
            "country_code": "US",
            "telephone_number": "319-356-1616",
            "fax_number": "319-356-4504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "KATHRYN",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-19",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "109264",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IA",
            "license": "109264",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IA",
            "license": "109264",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601010382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leslie, MI

Sources for this page

Verify at the official NPI Registry.