Individual provider Active NPI

Endre Vincent Brown, R.N.

  • Registered Nurse
  • Stone Mountain, GA
National Provider Identifier
1376845586
Registry record updated Nov 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN184874 Issued in GA
Practice address
770 Village Square Dr
Stone Mountain, GA 30083-3380
Phone
(404) 298-8998
Fax
(404) 298-7658
NPI assigned
Nov 19, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN184874 GA Primary

Addresses

Primary practice location

770 Village Square Dr
Stone Mountain, GA 30083-3380

Mailing address

770 Village Square Dr
Stone Mountain, GA 30083-3380
Phone (404) 298-8998

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN184874GAMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1290124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290124800000",
    "number": "1376845586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 VILLAGE SQUARE DR",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300833380",
            "telephone_number": "404-298-8998",
            "fax_number": "404-298-7658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 VILLAGE SQUARE DR",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300833380",
            "telephone_number": "404-298-8998",
            "fax_number": "404-298-7658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "ENDRE",
        "middle_name": "VINCENT",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-19",
        "last_updated": "2010-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN184874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stone Mountain, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2010; 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.