Active NPI
Douglas R Brown, R.P.A.C.
- Physician Assistant
- New Hartford, NY
National Provider Identifier
1316030919
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 005436
- Practice address
- 1729 Burrstone Rd
New Hartford, NY 13413-1001 - Phone
- (315) 798-1647
- Fax
- (315) 798-1565
- NPI assigned
- Oct 2, 2006
- Last updated
- Mar 29, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 005436 | NY | Primary |
Addresses
Primary practice location
1729 Burrstone Rd
New Hartford, NY 13413-1001
Mailing address
1729 Burrstone Rd
New Hartford, NY 13413-1001
Phone (315) 798-1647
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005436 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301356800000",
"number": "1316030919",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1729 BURRSTONE RD",
"city": "NEW HARTFORD",
"state": "NY",
"postal_code": "134131001",
"telephone_number": "315-798-1647",
"fax_number": "315-798-1565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1729 BURRSTONE RD",
"city": "NEW HARTFORD",
"state": "NY",
"postal_code": "134131001",
"telephone_number": "315-798-1647",
"fax_number": "315-798-1565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "DOUGLAS",
"middle_name": "R",
"credential": "R.P.A.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2011-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "005436",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Hartford, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.