Kacie M Brown

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1113 Korina Ave Unit a
Grand Forks Afb, ND 58204-1378

Phone

(614) 499-7950

NPI assigned

Jan 27, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1327622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327622400000",
    "number": "1174895833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1113 KORINA AVE UNIT A",
            "city": "GRAND FORKS AFB",
            "state": "ND",
            "postal_code": "582041378",
            "telephone_number": "614-499-7950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1113 KORINA AVE UNIT A",
            "city": "GRAND FORKS AFB",
            "state": "ND",
            "postal_code": "582041378",
            "telephone_number": "614-499-7950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "KACIE",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-27",
        "last_updated": "2012-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Romi Abouzedan, DPT
• Joseph Roland Adamson, MD
• Philip Ofimiano Borde Jr., IDMT
• Kathleen Andrea Brehm-Heitman, P.T.
• Seth Bridges, PSY.D
• Nicole J Chine, PT
• Johnathan Mark Compton, M.D.
• Marie Elyse Corbin, LCSW
• Dennise Cortes, MD
• Linda M Dunnigan, RN

• All providers in Grand Forks Afb, ND
• Physician Assistant in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.