Derek Brown, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

006112 Issued in NY

Practice address

39 W Main St
Canton, NY 13617-1358

Phone

(315) 379-4700

NPI assigned

Aug 15, 2023

Last updated

Aug 15, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1692057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1598548505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 KING ST",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136691142",
            "telephone_number": "315-713-5660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 W MAIN ST",
            "city": "CANTON",
            "state": "NY",
            "postal_code": "136171358",
            "telephone_number": "315-379-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "DEREK",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-15",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "006112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawn Lee Brabaw, LPN
• Haley Ann Brandes, PHARM D
• Kiri Pryjma Brandy, M.D.
• Danielle C. Brining-Plumadore, LMSW
• Susan E Britton, RN
• Joshua Brown
• Lisa Brown, RN
• Michael Brown, LCSW-R
• Ronald J. Brown, MED, CASAC
• Sarah N Buck-Morrill

• Physical Therapy Assistant in Canton, NY
• Providers in Canton, NY by specialty
• Physical Therapy Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; 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.