Active NPI
Christopher Coles Brown, MD
- Internal Medicine Physician
- Wakefield, RI
National Provider Identifier
1376569202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD11957
- Practice address
- 70 Kenyon Ave
Ste #B3
Wakefield, RI 02879 - Phone
- (401) 284-1808
- Fax
- (401) 284-1810
- NPI assigned
- Jul 14, 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD11957 | RI | Primary |
| Internal Medicine Physician | 207R00000X | 043365 | CT | |
| Internal Medicine Physician | 207R00000X | 5301A | WY | |
| Hospitalist Physician | 208M00000X | MD11957 | RI |
Addresses
Primary practice location
70 Kenyon Ave
Ste #B3
Wakefield, RI 02879
Mailing address
307 S Evergreen Ave
Woodbury, NJ 08096-2739
Phone (856) 686-4300
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 311984 | Other | RI | BLUE CROSS BLUE SHIELD |
| 413098 | Other | RI | BLUE CROSS BLUE SHIELD |
| 7058289 | Medicaid | RI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090403000068 | WY | Practitioner - Hospitalist | 5597779033 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 199 | WY | MD | Peer Specialist |
| 043365 | CT | MD | Internal Medicine Physician |
| MD11957 | RI | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Hospital of Converse County | Current | Accepting new patients | |
| Medicine and Long Term Care Associates, LLC | Internal Medicine | Past | Accepting new patients |
| Atlantic Professional Services of Rhode Island Incorporated | Hospitalist | Past | Accepting new patients |
Locations
111 S 5th St
Douglas, WY 82633
Phone (307) 358-6200
Organizations & group practices 3
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.
-
- Hospitalist Physician
- Wakefield, RI
- NPI 1922036946
Hospitalist
-
- Internal Medicine Physician
- Cranston, RI
- NPI 1073539227
Internal Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208822400000",
"number": "1376569202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "307 S EVERGREEN AVE",
"city": "WOODBURY",
"state": "NJ",
"postal_code": "080962739",
"telephone_number": "856-686-4300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "70 KENYON AVE",
"address_2": "STE #B3",
"city": "WAKEFIELD",
"state": "RI",
"postal_code": "02879",
"telephone_number": "401-284-1808",
"fax_number": "401-284-1810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "CHRISTOPHER",
"middle_name": "COLES",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-14",
"last_updated": "2008-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "RI",
"license": "MD11957",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CT",
"license": "043365",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WY",
"license": "5301A",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "RI",
"license": "MD11957",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "311984",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "413098",
"state": "RI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7058289",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Wakefield, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.