Marvella Brown

Primary specialty

Other TechnicianTaxonomy code 247200000X

Practice address

1718 Kalamazoo Ave SE
Grand Rapids, MI 49507-2117

Phone

(616) 634-9062

NPI assigned

Jul 1, 2014

Last updated

Jul 16, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Marvella Davis Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1404172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594857600000",
    "number": "1497161251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1718 KALAMAZOO AVE.",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49507",
            "telephone_number": "616-634-9062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1718 KALAMAZOO AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495072117",
            "telephone_number": "616-634-9062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "MARVELLA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-01",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARVELLA",
            "last_name": "DAVIS",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kristin Diane Brown, CNS
• Lisa Brown
• Lisa Brown, MD
• Madison Brown
• Mariel Brown, LMSW
• Matthew Alan Brown, DC
• Melanie Ann Brown, LMSW
• Michael D Brown, MD
• Michael Thomas Brown, PAC
• Nakia Brown

• Other Technician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Other Technician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2020; 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.