Active NPI
William M. Brown, M.D.
- Cardiovascular Disease Physician
- Marietta, GA
National Provider Identifier
1366404154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 21653
- Practice address
- 55 Whitcher St NE
Suite 350
Marietta, GA 30060-1155 - Phone
- (770) 424-6893
- Fax
- (770) 528-9938
- NPI assigned
- Apr 5, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nuclear Cardiology Physician | 207UN0901X | 21653 | GA | |
| Nuclear Imaging & Therapy Physician | 207UN0902X | 21653 | GA | |
| Cardiovascular Disease Physician | 207RC0000X | 21653 | GA | Primary |
Addresses
Primary practice location
55 Whitcher St NE
Suite 350
Marietta, GA 30060-1155
Mailing address
55 Whitcher St NE
Suite 350
Marietta, GA 30060-1155
Phone (770) 424-6893
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000244604V | Medicaid | GA | |
| 000244604T | Medicaid | GA | |
| 000244604X | Medicaid | GA | |
| 000244604S | Medicaid | GA | |
| 000244604U | Medicaid | GA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | wbrown4354@directwellstar.org |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 021653 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellstar Cardiovascular Medicine, LLC | Cardiovascular Disease | 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.
-
- Cardiovascular Disease Physician
- Marietta, GA
- NPI 1457320319
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569542400000",
"number": "1366404154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 WHITCHER ST NE",
"address_2": "SUITE 350",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300601155",
"telephone_number": "770-424-6893",
"fax_number": "770-528-9938"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 WHITCHER ST NE",
"address_2": "SUITE 350",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300601155",
"telephone_number": "770-424-6893",
"fax_number": "770-528-9938"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "WILLIAM",
"middle_name": "M.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-05",
"last_updated": "2019-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "207UN0901X",
"taxonomy_group": "",
"desc": "Nuclear Medicine, Nuclear Cardiology",
"state": "GA",
"license": "21653",
"primary": false
},
{
"code": "207UN0902X",
"taxonomy_group": "",
"desc": "Nuclear Medicine, Nuclear Imaging & Therapy",
"state": "GA",
"license": "21653",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "GA",
"license": "21653",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000244604V",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000244604T",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000244604X",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000244604S",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000244604U",
"state": "GA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "wbrown4354@directwellstar.org",
"affiliation": "N",
"address_1": "55 Whitcher St NE",
"address_2": "Suite 350",
"city": "Marietta",
"state": "GA",
"country_code": "US",
"postal_code": "300601155",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.