Bobby G Brown Jr., D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO767 Issued in AL

Practice address

124 S Memorial Dr
Prattville, AL 36067-3619

Phone

(334) 361-4267

Fax

(334) 361-3131

NPI assigned

Mar 9, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family PracticeAlso: Emergency Medicine

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jackson Hospital and Clinic, IncGroup PAC ID 0547254153, 119 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jackson Hospital & Clinic Inc Hospital, Montgomery, AL, CCN 010024

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Jackson Hospital and Clinic, Inc.

  • Emergency Medicine Physician
  • Montgomery, AL
  • NPI 1073264107

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Ivy Creek of Elmore, LLC

  dba Ivy Creek Family Care of Tallassee

  • Rural Health Clinic/Center
  • Tallassee, AL
  • NPI 1558868323
  Medicare reassignment NPD
• Nes Tennessee Inc

  • Emergency Medicine Physician
  • Montgomery, AL
  • NPI 1437606605
  Medicare reassignment NPD
• Community Hospital Inc

  • Rural Acute Care Hospital
  • Tallassee, AL
  • NPI 1730120726
  NPD
• Ivy Creek of Elmore, LLC

  dba Ivy Creek Family Care of Wetumpka

  • Rural Health Clinic/Center
  • Wetumpka, AL
  • NPI 1508480633

  Family Medicine

  NPD
• Ivycreek of Elmore LLC

  dba Elmore Community Hospital

  • Basic Emergency Medical Technician
  • Wetumpka, AL
  • NPI 1205034428
  NPD
• Jackson Hospital & Clinic, Inc.

  dba Jackson Pelvic Floor Therapy

  • Physical Therapist
  • Montgomery, AL
  • NPI 1265325823
  NPD
• Nes Tennessee Inc

  • Emergency Medicine Physician
  • Monroeville, AL
  • NPI 1013519230
  NPD
• Jackson Hospital and Clinic, Inc

  dba Jackson Clinic

  • Internal Medicine Physician
  • Montgomery, AL
  • NPI 1639314230
  NPD (past)

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

• Jackson Hospital & Clinic, Inc.

  • General Acute Care Hospital
  • Montgomery, AL
  • NPI 1043262488
  Care Compare affiliation

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336117183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 S MEMORIAL DR",
            "city": "PRATTVILLE",
            "state": "AL",
            "postal_code": "360673619",
            "telephone_number": "334-361-4267",
            "fax_number": "334-361-3131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 S MEMORIAL DR",
            "city": "PRATTVILLE",
            "state": "AL",
            "postal_code": "360673619",
            "telephone_number": "334-361-4267",
            "fax_number": "334-361-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "BOBBY",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "DO767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009998545",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "051528885",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bridger Pathology Laboratores, P.a.
• Bridgeway ABA Therapy, LLC (Bridgeway ABA Therapy)
• Donald Brobst, MD
• Gary Wayne Brooks
• Stefanie Daneen Brooks
• Lakeshia Brown, RN
• Bruno's Supermarkets, LLC. (Food World Pharmacy #245)
• Andrea Brush, CRNP FNP-C
• Karen Michelle Bryant, CRNP
• Emily Michelle Burdette, PT,DPT

• Family Medicine Physician in Prattville, AL
• Providers in Prattville, AL by specialty
• Family Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.