Individual provider Active NPI

Gary Ross Brown, MD

  • Dermatology Physician
  • Covington, LA
National Provider Identifier
1366418881
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD02912R Issued in LA
Practice address
1011 S Tyler St
Covington, LA 70433
Phone
(985) 893-2620
Fax
(985) 893-3050
NPI assigned
Feb 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD02912R LA Primary

Addresses

Primary practice location

1011 S Tyler St
Covington, LA 70433

Mailing address

1011 S Tyler St
Covington, LA 70433
Phone (985) 893-2620

Other identifiers 1

IdentifierTypeStateIssuer
1132896MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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

Enrollment IDStateProvider typePAC IDDetails
I20100505000036 LA Practitioner - Dermatology 3971631425 Practice locations: Covington, LA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD02912RLAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gary R. Brown, M.D. Dermatology PastSince Jul 1, 1999 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": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1366418881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 S TYLER ST",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "70433",
            "telephone_number": "985-893-2620",
            "fax_number": "985-893-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 S TYLER ST",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "70433",
            "telephone_number": "985-893-2620",
            "fax_number": "985-893-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "GARY",
        "middle_name": "ROSS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "LA",
            "license": "MD02912R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1132896",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, LA

Sources for this page

Verify at the official NPI Registry.