Individual provider Active NPI

Kendall P. Brown, M.D.

  • Neurodevelopmental Disabilities Physician
  • Dallas, TX
National Provider Identifier
1326083643
Registry record updated Jun 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurodevelopmental Disabilities PhysicianTaxonomy code 2084P0005X
License
M9885 Issued in TX
Practice address
2445 Pinebluff Dr
Dallas, TX 75228-5841
Phone
(254) 230-2095
Fax
(972) 767-4744
NPI assigned
Jun 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X M9885 TX
Geriatric Psychiatry Physician 2084P0805X M9885 TX
Neurodevelopmental Disabilities Physician 2084P0005X M9885 TX Primary

Addresses

Primary practice location

2445 Pinebluff Dr
Dallas, TX 75228-5841

Mailing address

2445 Pinebluff Dr
Dallas, TX 75228-5841
Phone (254) 230-2095

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M9885TXMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Milwaukee Psychiatry Past Accepting new patients

Organizations & group practices 1

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": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1326083643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2445 PINEBLUFF DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752285841",
            "telephone_number": "254-230-2095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2445 PINEBLUFF DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752285841",
            "telephone_number": "254-230-2095",
            "fax_number": "972-767-4744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "KENDALL",
        "middle_name": "P.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-19",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "M9885",
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "TX",
            "license": "M9885",
            "primary": false
        },
        {
            "code": "2084P0005X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurodevelopmental Disabilities",
            "state": "TX",
            "license": "M9885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.