Individual provider Active NPI

Valarie J Brown, HAIR LOSS SPECIALIST

  • Prosthetics Case Management
  • Ridgeland, MS
National Provider Identifier
1568859536
Registry record updated Apr 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetics Case ManagementTaxonomy code 1744P3200X
License
00-61359 Issued in MS
Practice address
105 W Ridgeland Ave
Ste 4
Ridgeland, MS 39157-2026
Phone
(601) 810-1392
NPI assigned
Apr 17, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetics Case Management 1744P3200X 00-61359 MS Primary

Addresses

Primary practice location

105 W Ridgeland Ave
Ste 4
Ridgeland, MS 39157-2026

Mailing address

5847 Canton Park Dr
Jackson, MS 39211-3433
Phone (601) 810-1392

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
00-61359MSMDProsthetics Case Management

NPI Registry JSON

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

{
    "created_epoch": "1429228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461801600000",
    "number": "1568859536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5847 CANTON PARK DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392113433",
            "telephone_number": "601-810-1392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 W RIDGELAND AVE",
            "address_2": "STE 4",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391572026",
            "telephone_number": "601-810-1392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "VALARIE",
        "middle_name": "J",
        "credential": "HAIR LOSS SPECIALIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-17",
        "last_updated": "2016-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "MS",
            "license": "00-61359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgeland, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2016; 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.