Active NPI
Samuel Y Brown, MD
- Pediatrics Physician
- Kenner, LA
National Provider Identifier
1225110489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 03309R
- Practice address
- 3813 Williams Blvd
Kenner, LA 70065-3007 - Phone
- (504) 443-5437
- NPI assigned
- Oct 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 03309R | LA | Primary |
Addresses
Primary practice location
3813 Williams Blvd
Kenner, LA 70065-3007
Mailing address
3813 Williams Blvd
Kenner, LA 70065-3007
Phone (504) 443-5437
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1136689 | Medicaid | LA |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03309R | LA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263945600000",
"number": "1225110489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3813 WILLIAMS BLVD",
"city": "KENNER",
"state": "LA",
"postal_code": "700653007",
"telephone_number": "504-443-5437"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3813 WILLIAMS BLVD",
"city": "KENNER",
"state": "LA",
"postal_code": "700653007",
"telephone_number": "504-443-5437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "SAMUEL",
"middle_name": "Y",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-19",
"last_updated": "2010-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "LA",
"license": "03309R",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1136689",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kenner, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.