Individual provider Active NPI

Caitlin Rose Brown, PA-C

  • Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1528752615
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9117913 Issued in FL
Practice address
8823 San Jose Blvd Ste 209
Jacksonville, FL 32217-4288
Phone
(904) 404-7044
Fax
(904) 329-2303
NPI assigned
Jun 2, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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 PA9117913 FL Primary

Addresses

Primary practice location

8823 San Jose Blvd Ste 209
Jacksonville, FL 32217-4288

Mailing address

8823 San Jose Blvd Ste 209
Jacksonville, FL 32217-4288
Phone (904) 404-7044

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240103000250 FL Practitioner - Physician Assistant 0648620658 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

916 Kingsbay Rd
Suite B
Saint Marys, GA 31558-3745
Phone (912) 576-3802

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9117913FLMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: caitlin.brown.1@23145.direct.athenahealth.com

Organizations & group practices 2

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 3

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": "1685664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1528752615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8823 SAN JOSE BLVD STE 209",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322174288",
            "telephone_number": "904-404-7044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8823 SAN JOSE BLVD STE 209",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322174288",
            "telephone_number": "904-404-7044",
            "fax_number": "904-329-2303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "CAITLIN",
        "middle_name": "ROSE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-02",
        "last_updated": "2024-04-25",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9117913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.