NPIMap

Individual provider Active NPI

Ryan William Brown, M.D.

  • Emergency Medicine Physician
  • Jackson, MS
National Provider Identifier
1245619642
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
25659 Issued in MS
Practice address
2500 N State St
Jackson, MS 39216-4500
Phone
(601) 984-1000
NPI assigned
May 19, 2015
Last updated
Aug 11, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 25659 MS Primary

Addresses

Primary practice location

2500 N State St
Jackson, MS 39216-4500

Mailing address

935 Elmwood St
Shreveport, LA 71104-4803

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20201125001749 LA Practitioner - Emergency Medicine 0446568661 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Louisiana State University School of Medicine in Shreveport, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Highland Emergency Group, LLCGroup PAC ID 6800295890, 42 clinicians

Practice addresses (Care Compare)

2531 Viking Dr
Bossier City, LA 71111-2103
Phone (318) 681-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25659MSMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cross Lake Emergency Group, LLC Emergency Medicine CurrentSince Oct 23, 2020 Accepting new patients
Highland Emergency Group, LLC Emergency Medicine CurrentSince Apr 28, 2021 Accepting new patients
Sound Physicians Emergency Medicine of Louisiana Inc Emergency Medicine CurrentSince Mar 1, 2020 Accepting new patients
Healthcare Plus Limited Liability Company Past Accepting new patients
Christus Health Northern Louisiana Past Accepting new patients

Locations

2531 Viking Dr
Bossier City, LA 71111
Phone (318) 681-7000

524 Dr Michael Debakey Dr
Lake Charles, LA 70601
Phone (337) 430-4455

1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105
Phone (318) 681-4138

1453 E Bert Kouns Industrial Loop
#L
Shreveport, LA 71105

2510 Bert Kouns Industrial Loop
Shreveport, LA 71118
Phone (318) 212-5000

8001 Youree Dr
Shreveport, LA 71115
Phone (318) 212-3000

Organizations & group practices 5

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 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1431993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1245619642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 ELMWOOD ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711044803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "RYAN",
        "middle_name": "WILLIAM",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-19",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "25659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.