Active NPI
Douglas G. Brown, M.S.
- Audiologist
- Syracuse, NY
National Provider Identifier
1184756629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 308
- Practice address
- 5992 E Molloy Rd
Syracuse, NY 13211-2130 - Phone
- (315) 410-1295
- NPI assigned
- Mar 11, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 308 | NY | Primary |
Addresses
Primary practice location
5992 E Molloy Rd
Syracuse, NY 13211-2130
Mailing address
5992 E Molloy Rd
Syracuse, NY 13211-2130
Phone (315) 410-1295
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00599606 | Medicaid | NY |
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)
- Enrolled
- Credentials
- Doctor of Medicine, Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 308 | NY | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331856000000",
"number": "1184756629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5992 E MOLLOY RD",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132112130",
"telephone_number": "315-410-1295"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5992 E MOLLOY RD",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132112130",
"telephone_number": "315-410-1295"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "DOUGLAS",
"middle_name": "G.",
"credential": "M.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-11",
"last_updated": "2012-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "NY",
"license": "308",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00599606",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.