Individual provider Active NPI

Mickey Brown

  • Adult Health Nurse Practitioner
  • Birmingham, AL
National Provider Identifier
1295139509
Registry record updated Oct 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
1-130720 Issued in AL
Practice address
1802 6TH Ave S
Birmingham, AL 35233-1932
Phone
(205) 934-5105
NPI assigned
Oct 15, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 1-130720 AL Primary

Addresses

Primary practice location

1802 6TH Ave S
Birmingham, AL 35233-1932

Mailing address

1802 6TH Ave. S.
Birmingham, AL 35249
Phone (205) 934-5105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20150309002083 AL Practitioner - Nurse Practitioner 9436475548 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Alabama School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cypress Healthcare, LLCGroup PAC ID 8224206388, 14 clinicians

Practice addresses (Care Compare)

727 Memorial Dr
Bessemer, AL 35022-6029
Phone (334) 701-7288

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-130720ALMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama at Birmingham CurrentSince Nov 9, 2014 Accepting new patients
University of Alabama at Birmingham Current Accepting new patients
University of Alabama at Birmingham CurrentSince Nov 9, 2014 Accepting new patients
Cypress Healthcare, LLC CurrentSince Mar 11, 2015 Accepting new patients

Locations

727 Memorial Dr
Bessemer, AL 35022
Phone (205) 332-3160

860 Montclair Rd
Ste 955
Birmingham, AL 35213
Phone (205) 332-3160

1802 6th Ave S
Birmingham, AL 35233
Phone (205) 934-5105

1806 6th Ave S
Irondale, AL 35210
Phone (205) 975-7389

2868 Acton Rd
Vestavia, AL 35243
Phone (205) 592-4222

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1413331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413331200000",
    "number": "1295139509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 6TH AVE. S.",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35249",
            "telephone_number": "205-934-5105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 6TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331932",
            "telephone_number": "205-934-5105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "MICKEY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-15",
        "last_updated": "2014-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AL",
            "license": "1-130720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.