Individual provider Active NPI

Jermaine L Brown

  • Driver
  • Houston, TX
National Provider Identifier
1477076560
Registry record updated Aug 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
License
14502074 Issued in TX
Practice address
4631 Callery Creek Dr
Houston, TX 77053
Phone
(832) 432-1656
NPI assigned
Jul 20, 2017
Sex
Male
Sole proprietor
Yes

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
14502074TXMDDriver

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
DriverGroup: 193400000X SINGLE SPECIALTY GROUP 172A00000X 14502074 TX Primary

Addresses

NPPES NPI Registry

Primary practice location

4631 Callery Creek Dr
Houston, TX 77053

Mailing address

4631 Callery Creek Dr
Houston, TX 77053-3352
Phone (832) 432-1656

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 17, 2017.

{
    "created_epoch": "1500508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502928000000",
    "number": "1477076560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4631 CALLERY CREEK DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770533352",
            "telephone_number": "832-432-1656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4631 CALLERY CREEK DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77053",
            "telephone_number": "832-432-1656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JERMAINE",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-20",
        "last_updated": "2017-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Driver",
            "state": "TX",
            "license": "14502074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

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