Individual provider Active NPI

Robin Southerland Brown, OT

  • Occupational Therapy Assistant
  • Natchez, MS
National Provider Identifier
1235277278
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
2659 Issued in SC
Practice address
46 Old Courthouse Rd
Natchez, MS 39120-8436
Phone
(601) 520-1826
Fax
(855) 952-2013
NPI assigned
Feb 2, 2007
Last updated
Jul 30, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 2659 SC Primary

Addresses

Primary practice location

46 Old Courthouse Rd
Natchez, MS 39120-8436

Mailing address

2222 Sullivan TRL
Easton, PA 18040-7958

Other practice location 1

35 Beach City Rd
Hilton Head, SC 29926-4725
Phone (843) 342-5599

Other practice location 2

610 Market St
Port Gibson, MS 39150-2330
Phone (601) 437-3299

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, LA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200721001305 MS Practitioner - Occupational Therapist in Private Practice 7113341363
I20210211003549 LA Practitioner - Occupational Therapist in Private Practice 7113341363

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2659SCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Physical Therapy,Inc. Past Accepting new patients
Key Rehab Associates, Inc. Past Accepting new patients
Delta Therapy Solutions, LLC PastSince Feb 23, 2020 Accepting new patients
Ellard Physical Therapy PastSince Jun 14, 2020 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": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1235277278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 SULLIVAN TRL",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180407958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 OLD COURTHOUSE RD",
            "city": "NATCHEZ",
            "state": "MS",
            "postal_code": "391208436",
            "telephone_number": "601-520-1826",
            "fax_number": "855-952-2013"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35 Beach City Rd",
            "address_purpose": "LOCATION",
            "city": "Hilton Head",
            "state": "SC",
            "postal_code": "299264725",
            "country_code": "US",
            "telephone_number": "843-342-5599",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "610 Market St",
            "address_purpose": "LOCATION",
            "city": "Port Gibson",
            "state": "MS",
            "postal_code": "391502330",
            "country_code": "US",
            "telephone_number": "601-437-3299",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "ROBIN",
        "middle_name": "SOUTHERLAND",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "SC",
            "license": "2659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Natchez, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.