NPIMap

Individual provider Active NPI

Jonathan Davis Brown

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1487009759
Registry record updated Jul 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-06234 Issued in NC
Practice address
125 Queens Rd Ste 200
Charlotte, NC 28204-3215
Phone
(704) 343-9800
Fax
(704) 347-2011
NPI assigned
Apr 25, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2522 SC
Physician Assistant 363A00000X 0010-06234 NC Primary

Addresses

Primary practice location

125 Queens Rd Ste 200
Charlotte, NC 28204-3215

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 343-9800

Other practice location 1

196 Cardiology Drive
rock Hill, SC 29732
Phone (803) 324-5135

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211124001111 NC Practitioner - Physician Assistant 8123385242 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Presbyterian HospitalGroup PAC ID 1153231907, 412 clinicians

Practice addresses (Care Compare)

125 Queens Rd
Charlotte, NC 28204-3215

Hospital & facility affiliations

  • Novant Health Presbyterian Medical Center Hospital, Charlotte, NC, CCN 340053

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Nov 20, 2021 Accepting new patients
Novant Medical Group, Inc. CurrentSince Nov 20, 2021 Accepting new patients
The Presbyterian Hospital CurrentSince Nov 20, 2021 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Nov 20, 2021 Accepting new patients
The Presbyterian Hospital CurrentSince Nov 20, 2021 Accepting new patients
Novant Medical Group, Inc. Past Accepting new patients

Locations

301 Hawthorne Ln
Ste 200
Charlotte, NC 28204
Phone (704) 316-5100

125 Queens Rd
Ste 200
Charlotte, NC 28204

6324 Fairview Rd
Ste 330
Charlotte, NC 28210
Phone (704) 316-1950

335 N Caswell Rd
Charlotte, NC 28204
Phone (704) 384-7390

125 Baldwin Ave
Ste 200
Charlotte, NC 28204
Phone (704) 384-5043

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: jbrown1004030@direct.novanthealth.org

Organizations & group practices 18

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.

View all 18

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": "1461542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1487009759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-343-9800",
            "fax_number": "704-347-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 QUEENS RD STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043215",
            "telephone_number": "704-343-9800",
            "fax_number": "704-347-2011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "196 Cardiology Drive",
            "address_purpose": "LOCATION",
            "city": "rock Hill",
            "state": "SC",
            "postal_code": "29732",
            "country_code": "US",
            "telephone_number": "803-324-5135",
            "fax_number": "803-324-8161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JONATHAN",
        "middle_name": "DAVIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-25",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "2522",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-06234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.