Individual provider Active NPI

Bertrand Brown, CPS-AD

  • Social Worker
  • Atlanta, GA
National Provider Identifier
1528693108
Registry record updated Mar 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
000000000 Issued in GA
Practice address
1017 Fayetteville Rd SE
Atlanta, GA 30316-2932
Phone
(678) 629-1370
NPI assigned
Mar 4, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Social Worker 104100000X 000000000 GA Primary

Addresses

Primary practice location

1017 Fayetteville Rd SE
Atlanta, GA 30316-2932

Mailing address

1017 Fayetteville Rd SE
Atlanta, GA 30316-2932
Phone (678) 629-1370

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

NPI Registry JSON

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

{
    "created_epoch": "1583280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1528693108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 FAYETTEVILLE RD SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303162932",
            "telephone_number": "678-629-1370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 FAYETTEVILLE RD SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303162932",
            "telephone_number": "678-629-1370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "BERTRAND",
        "credential": "CPS-AD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-04",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "GA",
            "license": "000000000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.