NPIMap

Organization Active NPI

Ford Brewer, MD, Inc

Doing business as Google Wellness Center

  • General Practice Physician
  • Venice, CA
National Provider Identifier
1609151638
Registry record updated Aug 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
FORD BREWER, MD, INC
Doing business as
Google Wellness Center
Practice address
640 Main St
Venice, CA 90291-2524
Phone
(650) 214-6369
NPI assigned
Oct 21, 2011
Last updated
Aug 16, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
CHS HEALTH SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 16, 2016

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

Authorized official

Name
Stuart Clark
Title
Executive VP
Phone
(703) 760-0700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X Primary

Addresses

Primary practice location

640 Main St
Venice, CA 90291-2524

Mailing address

5500 Maryland Way
Ste 400
Brentwood, TN 37027-4948

Other names 1

  • Google Wellness Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ford Brewer MD Inc11 organizations share this tax ID, including this one
Part of
Google Wellness Center 345

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

640 Main St
Venice, CA 90291
Phone (650) 214-6369

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1319155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471305600000",
    "number": "1609151638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MARYLAND WAY",
            "address_2": "STE 400",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 MAIN ST",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902912524",
            "telephone_number": "650-214-6369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORD BREWER, MD, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHS HEALTH SERVICES",
        "enumeration_date": "2011-10-21",
        "last_updated": "2016-08-16",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "STUART",
        "authorized_official_title_or_position": "EXECUTIVE VP",
        "authorized_official_telephone_number": "703-760-0700"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Google Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Venice, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.