Individual provider Active NPI

Sharon D. Brown, PSY.D.

  • Clinical Psychologist
  • Dayton, OH
National Provider Identifier
1598769051
Registry record updated Feb 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3921 Issued in OH
Practice address
1250 W Dorothy LN
Ste 104
Dayton, OH 45409-1327
Phone
(937) 294-6612
Fax
(937) 236-0661
NPI assigned
Jun 11, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 3921 OH Primary

Addresses

Primary practice location

1250 W Dorothy LN
Ste 104
Dayton, OH 45409-1327

Mailing address

1250 W Dorothy LN
Ste 104
Dayton, OH 45409-1327
Phone (937) 294-6612

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050722000303 OH Practitioner - Clinical Psychologist 7517994429 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1250 W Dorothy LN
Suite 104
Dayton, OH 45409-1327
Phone (937) 294-6612

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3921OHMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sharon D Brown, Psy.D., LLC Clinical CurrentSince Jul 23, 1995 Accepting new patients

Locations

1250 W Dorothy Ln
Ste 104
Dayton, OH 45409
Phone (937) 294-6612

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1118448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488240000000",
    "number": "1598769051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 W DOROTHY LN",
            "address_2": "STE 104",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454091327",
            "telephone_number": "937-294-6612",
            "fax_number": "937-236-0661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 W DOROTHY LN",
            "address_2": "STE 104",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454091327",
            "telephone_number": "937-294-6612",
            "fax_number": "937-236-0661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "SHARON",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-11",
        "last_updated": "2017-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "3921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.