Individual provider Active NPI

Rebecca Brown, DC

  • Chiropractor
  • Yarmouth, ME
National Provider Identifier
1457355182
Registry record updated Mar 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CR822 Issued in ME
Practice address
50 Forest Falls Dr
Suite 4
Yarmouth, ME 04096-6937
Phone
(207) 846-5111
Fax
(207) 846-5988
NPI assigned
Jun 10, 2005
Reactivated
Mar 20, 2006
Last updated
Mar 17, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CR822 ME Primary

Addresses

Primary practice location

50 Forest Falls Dr
Suite 4
Yarmouth, ME 04096-6937

Mailing address

50 Forest Falls Dr
Ste 4
Yarmouth, ME 04096-6937
Phone (207) 846-5111

Other identifiers 3

IdentifierTypeStateIssuer
MM5922OtherMEDICARE PTAN
037903OtherMEBLUECROSSBLUESHIELDANTHEM
2265916OtherMEAETNA

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

State licenses

LicenseStateTypeSpecialty
CR822MEMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Brown Chiropractic LLC Chiropractor CurrentSince Jan 1, 2010 Accepting new patients
Me Integrative Health Services LLC Chiropractor PastSince Oct 1, 2010 Accepting new patients

Locations

50 Forest Falls Dr
Ste 4
Yarmouth, ME 04096
Phone (207) 846-5111

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489708800000",
    "number": "1457355182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 FOREST FALLS DR",
            "address_2": "STE 4",
            "city": "YARMOUTH",
            "state": "ME",
            "postal_code": "040966937",
            "telephone_number": "207-846-5111",
            "fax_number": "207-846-5988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 FOREST FALLS DR",
            "address_2": "SUITE 4",
            "city": "YARMOUTH",
            "state": "ME",
            "postal_code": "040966937",
            "telephone_number": "207-846-5111",
            "fax_number": "207-846-5988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "REBECCA",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-10",
        "last_updated": "2017-03-17",
        "deactivation_date": "2006-03-15",
        "reactivation_date": "2006-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ME",
            "license": "CR822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "MM5922",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUESHIELDANTHEM",
            "identifier": "037903",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2265916",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yarmouth, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2017; 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.