Individual provider Active NPI

Brandy Latisha Brown, FNP

  • Family Nurse Practitioner
  • Mooresville, NC
National Provider Identifier
1366073009
Registry record updated Feb 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5012854 Issued in NC
Practice address
128 E Plaza Dr
Mooresville, NC 28115-8000
Phone
(833) 750-1142
NPI assigned
Jan 31, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5012854 NC Primary
Nurse Practitioner 363L00000X 5012854 NC

Addresses

Primary practice location

128 E Plaza Dr
Mooresville, NC 28115-8000

Mailing address

128 E Plaza Dr
Mooresville, NC 28115-8000
Phone (833) 750-1142

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20201105000758 NC Practitioner - Nurse Practitioner 4688084429 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5012854NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Addiction Recovery Medical Services Past Accepting new patients

Organizations & group practices 2

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": "1580428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770508800000",
    "number": "1366073009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 E PLAZA DR",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281158000",
            "telephone_number": "833-750-1142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 E PLAZA DR",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281158000",
            "telephone_number": "833-750-1142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "BRANDY",
        "middle_name": "LATISHA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-31",
        "last_updated": "2026-02-08",
        "certification_date": "2026-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5012854",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5012854",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

Verify at the official NPI Registry.