Individual provider Active NPI

Nicole Brown, PA-C

  • Medical Physician Assistant
  • Muncie, IN
National Provider Identifier
1225374465
Registry record updated Nov 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
10001482A Issued in IN
Practice address
2401 W University Ave
Muncie, IN 47303-3428
Phone
(765) 751-1720
Fax
(765) 281-6567
NPI assigned
Dec 17, 2012
Last updated
Nov 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2020

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 10001482A IN Primary

Addresses

Primary practice location

2401 W University Ave
Muncie, IN 47303-3428

Mailing address

250 N Shadeland Ave
Ste 130 Provider Enrollment
Indianapolis, IN 46219-4959

Other practice location 1

2400 17th St
Columbus, IN 47201-5351
Phone (812) 379-4441

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nbrown8546@edirect.crh.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20130509000616 IN Practitioner - Physician Assistant 8628215761 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Nora Urgent Care LLC CurrentSince Apr 1, 2016 Accepting new patients
Indiana University Health Care Associates, Inc CurrentSince Jan 15, 2013 Accepting new patients

Locations

5208 Reliable Pkwy
Chicago, IL 60686

2400 17th St
Columbus, IN 47201
Phone (812) 373-3025

1701 N Senate Blvd
Bldg C6
Indianapolis, IN 46202
Phone (913) 962-2000

250 N Shadeland Ave
Ste 130
Indianapolis, IN 46219
Phone (317) 962-4836

860 E 86th St
Ste 4
Indianapolis, IN 46240
Phone (317) 975-3441

2401 W University Ave
Muncie, IN 47303
Phone (765) 747-3111

Interoperability endpoints

  • Direct secure messaging: nbrown8546@edirect.crh.org

Organizations & group practices 3

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": "1355702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604361600000",
    "number": "1225374465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "address_2": "STE 130 PROVIDER ENROLLMENT",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 W UNIVERSITY AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473033428",
            "telephone_number": "765-751-1720",
            "fax_number": "765-281-6567"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2400 17th St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "IN",
            "postal_code": "472015351",
            "country_code": "US",
            "telephone_number": "812-379-4441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-17",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IN",
            "license": "10001482A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nbrown8546@edirect.crh.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2400 17th St",
            "city": "Columbus",
            "state": "IN",
            "country_code": "US",
            "postal_code": "472015351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Muncie, IN

Sources for this page

Verify at the official NPI Registry.