Individual provider Active NPI

Willie Lee Brown

  • Home Health Agency
  • Portsmouth, VA
National Provider Identifier
1548415193
Registry record updated Nov 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
35674 Issued in VA
Practice address
600 Crawford St
Suite P-D
Portsmouth, VA 23704-3820
Phone
(757) 393-0660
Fax
(757) 393-0667
NPI assigned
Nov 24, 2008
Last updated
Nov 24, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 35674 VA Primary
Community Based Hospice Care Agency 251G00000X NU
In Home Supportive Care Agency 253Z00000X NU

Addresses

Primary practice location

600 Crawford St
Suite P-D
Portsmouth, VA 23704-3820

Mailing address

600 Crawford St
Suite P-D
Portsmouth, VA 23704-3820
Phone (757) 393-0660

Other identifiers 1

IdentifierTypeStateIssuer
30-0260056MedicaidVA

Other names 1

  • Mr. Willie Lee Brown Other name

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
35674VAMDHome Health Agency

NPI Registry JSON

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

{
    "created_epoch": "1227484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227484800000",
    "number": "1548415193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 CRAWFORD ST",
            "address_2": "SUITE P-D",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237043820",
            "telephone_number": "757-393-0660",
            "fax_number": "757-393-0667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 CRAWFORD ST",
            "address_2": "SUITE P-D",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237043820",
            "telephone_number": "757-393-0660",
            "fax_number": "757-393-0667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "WILLIE",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-24",
        "last_updated": "2008-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "VA",
            "license": "35674",
            "primary": true
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30-0260056",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WILLIE",
            "last_name": "BROWN",
            "middle_name": "LEE",
            "prefix": "MR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Portsmouth, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2008; 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.