Nicole Elizabeth Brown, PA
Individual provider Active NPI Physician Assistant · Fredericksburg, VA
NPI 1578878740 · NPPES record last updated Mar 6, 2025
Key facts
- NPI
- 1578878740
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 0110010578 (VA)
- Practice address
- 1101 Sam Perry Blvd Ste 314
Fredericksburg, VA 22401-4466 - Phone
- (540) 374-3200
- NPI assigned
- Aug 12, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mary Washington Healthcare Providers LLC
Practice addresses (Care Compare)
1001 Sam Perry Blvd
Fredericksburg, VA 22401-4453
Phone (540) 741-5610
101 Hospital Ctr Blvd
Stafford, VA 22554-6200
Phone (540) 741-5610
Hospital & facility affiliations
- Mary Washington Hospital
- Stafford Hospital, LLC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TX, VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200110000983 | TX | Practitioner - Physician Assistant | 4082808084 | |
| I20250129001863 | VA | Practitioner - Physician Assistant | 4082808084 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA13285 | TX | MD | Physician Assistant |
| 0110010578 | VA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mary Washington Healthcare Physicians | Current |
Accepting new patients | |
| Northwestern Medical Center, Inc. | Past | Accepting new patients | |
| Mary Washington Hospital Inc. | Past | Accepting new patients |
Interoperability endpoints
- nbrown281077@ahs.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0110010578 | VA | Yes |
| Physician Assistant | 363A00000X | 002420 | CT | |
| Physician Assistant | 363A00000X | PA13285 | TX | |
| Medical Physician Assistant | 363AM0700X | 002420 | CT |
Addresses
Primary practice location
1101 Sam Perry Blvd Ste 314
Fredericksburg, VA 22401-4466
Mailing address
705 Quail Creek Dr
Amarillo, TX 79124-1608
Other practice location 1
705 Quail Creek Dr
Amarillo, TX 79124-1608
Phone (802) 524-5911
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003024205 | Medicaid | CT |
Other names
- Nicole Elizabeth Kern
Other providers in Fredericksburg, VA
- Linda D Brown
- Michael Brown
- Michael J Brown
- Monica J Brown
- Nicole Brown
- Nyneesha Brown
- Robyn Brown
- Victoria Brown
- Zechaira Brown
- Latham Issac Browning
All providers in Fredericksburg, VA · Physician Assistant in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.