Individual provider Active NPI

William G Brown, PA

  • Medical Physician Assistant
  • Du Bois, PA
National Provider Identifier
1215158357
Registry record updated Aug 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA000173L Issued in PA
Practice address
20 Industrial Dr
Acute Care Clinic
Du Bois, PA 15801-3842
Phone
(814) 375-6071
Fax
(814) 375-6073
NPI assigned
May 2, 2007
Last updated
Aug 10, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA000173L PA Primary

Addresses

Primary practice location

20 Industrial Dr
Acute Care Clinic
Du Bois, PA 15801-3842

Mailing address

300 E Main St
PO Box 189
Reynoldsville, PA 15851-1282
Phone (814) 375-6071

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA000173LPAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dubois Regional Medical Group, PC Past Accepting new patients
Dubois Regional Medical Center Past Accepting new patients
DRMG Opthalmology Past Accepting new patients
Dubois Regional Medical Group PC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312934400000",
    "number": "1215158357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MAIN ST",
            "address_2": "PO BOX 189",
            "city": "REYNOLDSVILLE",
            "state": "PA",
            "postal_code": "158511282",
            "telephone_number": "814-375-6071",
            "fax_number": "814-375-6073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 INDUSTRIAL DR",
            "address_2": "ACUTE CARE CLINIC",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158013842",
            "telephone_number": "814-375-6071",
            "fax_number": "814-375-6073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "WILLIAM",
        "middle_name": "G",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2011-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA000173L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Du Bois, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2011; 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.