NPIMap

Individual provider Active NPI

Kevin Frank Brown, D.O.

  • Family Medicine Physician
  • Bullhead City, AZ
National Provider Identifier
1245233980
Registry record updated Aug 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4550 Issued in AZ
Practice address
2812 Silver Creek Rd
Bullhead City, AZ 86442-8309
Phone
(928) 763-7404
Fax
(928) 763-9795
NPI assigned
May 25, 2005
Last updated
Aug 24, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4550 AZ Primary

Addresses

Primary practice location

2812 Silver Creek Rd
Bullhead City, AZ 86442-8309

Mailing address

3880 Stockton Hill Rd
Suite 103-135
Kingman, AZ 86409-0595
Phone (928) 377-9182

Other practice location 1

3131 Western Ave
Kingman, AZ 86401-0951
Phone (928) 718-0718

Other identifiers 4

IdentifierTypeStateIssuer
185299MedicaidAZ
P00424009OtherAZRAILROAD MEDICARE PTAN
AZ4550OtherAZLICENSE
Z116535OtherAZMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070328000366 AZ Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 9537060637 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paragon Physical Therapy and Rehab LLCGroup PAC ID 4284902339, 87 clinicians

Practice addresses (Care Compare)

2585 Miracle Mile
Bullhead City, AZ 86442-7522

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
4550AZMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kingman Family Practice, P.C. Family Medicine CurrentSince Sep 1, 2007 Accepting new patients
The Lingenfelter Center, LTD Past Accepting new patients
Monolith Diagnostics, PC PastSince Dec 3, 2019 Accepting new patients
Silver Ridge Management Inc Past Accepting new patients
Healthcare Management Professional, Inc. Past Accepting new patients
Kingman Healthcare, Inc Family Medicine Past Accepting new patients

Locations

2812 Silver Creek Rd
Bullhead City, AZ 86442
Phone (928) 763-1404

1739 E Beverly Ave
Ste 209
Kingman, AZ 86409
Phone (928) 627-8520

3131 Western Ave
Kingman, AZ 86401
Phone (928) 718-0718

3269 N Stockton Hill Rd
Kingman, AZ 86409
Phone (928) 757-0626

3880 N Stockton Hill Rd
#103135
Kingman, AZ 86409
Phone (928) 529-7744

3880 N Stockton Hill Rd
Ste 103135
Kingman, AZ 86409
Phone (928) 757-1444

Organizations & group practices 7

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1116979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566604800000",
    "number": "1245233980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3880 STOCKTON HILL RD",
            "address_2": "SUITE 103-135",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864090595",
            "telephone_number": "928-377-9182",
            "fax_number": "702-900-9648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2812 SILVER CREEK RD",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864428309",
            "telephone_number": "928-763-7404",
            "fax_number": "928-763-9795"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3131 Western Ave",
            "address_purpose": "LOCATION",
            "city": "Kingman",
            "state": "AZ",
            "postal_code": "864010951",
            "country_code": "US",
            "telephone_number": "928-718-0718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "KEVIN",
        "middle_name": "FRANK",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-25",
        "last_updated": "2019-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "4550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "185299",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "P00424009",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "AZ4550",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "Z116535",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bullhead City, AZ

Sources for this page

Verify at the official NPI Registry.