Individual provider Active NPI

Kylie Brown

  • Physician Assistant
  • Terre Haute, IN
National Provider Identifier
1467186742
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
102 Derbe CT
Terre Haute, IN 47803-9464
Phone
(859) 609-5718
NPI assigned
Jul 13, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

102 Derbe CT
Terre Haute, IN 47803-9464

Mailing address

102 Derbe CT
Terre Haute, IN 47803-9464

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240927003104 ME Practitioner - Physician Assistant 0345771531 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

50 Union St
Ellsworth, ME 04605-1534

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Maine Coast Regional Health Facilities CurrentSince Sep 15, 2024 Accepting new patients
The Blue Hill Memorial Hospital CurrentSince Sep 15, 2024 Accepting new patients
Maine Coast Regional Health Facilities CurrentSince Sep 15, 2024 Accepting new patients

Locations

57 Water St
Blue Hill, ME 04614
Phone (207) 374-3400

43 Whiting Hill Rd
Ste 200
Brewer, ME 04412
Phone (800) 757-3326

43 Whiting Hill Rd
Ste 250
Brewer, ME 04412

50 Union St
Ellsworth, ME 04605
Phone (207) 664-5304

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1657670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1467186742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 DERBE CT",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478039464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 DERBE CT",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478039464",
            "telephone_number": "859-609-5718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "KYLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-13",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

Verify at the official NPI Registry.