Active NPI
Jenny Brown, CPA
- Medical Physician Assistant
- Raleigh, NC
National Provider Identifier
1215191549
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 0010-01408
- Practice address
- 2810 Wakefield Pines Dr Ste 115
Raleigh, NC 27614-7078 - Phone
- (919) 488-0111
- Fax
- (919) 488-0104
- NPI assigned
- Jul 16, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 0010-01408 | NC | Primary |
Addresses
Primary practice location
2810 Wakefield Pines Dr Ste 115
Raleigh, NC 27614-7078
Mailing address
2810 Wakefield Pines Dr Ste 115
Raleigh, NC 27614-7078
Phone (919) 488-0111
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0010-01408 | NC | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216166400000",
"number": "1215191549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2810 WAKEFIELD PINES DR STE 115",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276147078",
"telephone_number": "919-488-0111",
"fax_number": "919-488-0104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2810 WAKEFIELD PINES DR STE 115",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276147078",
"telephone_number": "919-488-0111",
"fax_number": "919-488-0104"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "JENNY",
"credential": "CPA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-16",
"last_updated": "2008-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NC",
"license": "0010-01408",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.