Individual provider Active NPI

William M. Brown, M.D.

  • Cardiovascular Disease Physician
  • Marietta, GA
National Provider Identifier
1366404154
Registry record updated Sep 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
21653 Issued in GA
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

Updated by the provider on Sep 27, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
000244604VMedicaidGA
000244604TMedicaidGA
000244604XMedicaidGA
000244604SMedicaidGA
000244604UMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
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

LicenseStateTypeSpecialty
021653GAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.