Individual provider Active NPI

Candy Gale Brown, L.M., CLS

  • Midwife
  • Beverly Hills, FL
National Provider Identifier
1417042847
Registry record updated Apr 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
MW77 Issued in FL
Practice address
47 S Osceola St
Beverly Hills, FL 34465-3602
Phone
(352) 270-8722
NPI assigned
Oct 3, 2006
Last updated
Apr 30, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X MW77 FL Primary
Medical Technologist 246QM0706X TN0028829 FL

Addresses

Primary practice location

47 S Osceola St
Beverly Hills, FL 34465-3602

Mailing address

47 S Osceola St
Beverly Hills, FL 34465-3602
Phone (352) 270-8722

Other identifiers 1

IdentifierTypeStateIssuer
340032800MedicaidFL

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

State licenses

LicenseStateTypeSpecialty
MW77FLMDMidwife
TN0028829FLMDMedical Technologist

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304121600000",
    "number": "1417042847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 S OSCEOLA ST",
            "city": "BEVERLY HILLS",
            "state": "FL",
            "postal_code": "344653602",
            "telephone_number": "352-270-8722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 S OSCEOLA ST",
            "city": "BEVERLY HILLS",
            "state": "FL",
            "postal_code": "344653602",
            "telephone_number": "352-270-8722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "CANDY",
        "middle_name": "GALE",
        "credential": "L.M., CLS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2011-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "FL",
            "license": "MW77",
            "primary": true
        },
        {
            "code": "246QM0706X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Pathology, Medical Technologist",
            "state": "FL",
            "license": "TN0028829",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340032800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2011; 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.