Individual provider Active NPI

D William Brown Jr.

  • Obstetrics & Gynecology Physician
  • Santa Fe, NM
National Provider Identifier
1639295181
Registry record updated Apr 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
84153 Issued in NM
Practice address
546 Harkle Rd
Suite a
Santa Fe, NM 87505-4784
Phone
(505) 983-6467
Fax
(505) 983-2715
NPI assigned
Mar 22, 2007
Last updated
Apr 20, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 84153 NM Primary

Addresses

Primary practice location

546 Harkle Rd
Suite a
Santa Fe, NM 87505-4784

Mailing address

546 Harkle Rd
Suite a
Santa Fe, NM 87505-4784
Phone (505) 983-6467

Other identifiers 4

IdentifierTypeStateIssuer
201001168OtherNMPHP
00NM000453OtherNMBCBS ID
33621MedicaidNM
850344938OtherNMFEIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120718000544 NM Practitioner - Obstetrics/Gynecology 1951567015 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of North Dakota School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent HospitalGroup PAC ID 6608775135, 335 clinicians

Practice addresses (Care Compare)

1622 Galisteo St
Suite 200
Santa Fe, NM 87505-4774
Phone (505) 984-0303

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
84153NMMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services Obstetrics & Gynecology CurrentSince Sep 5, 2017 Accepting new patients
Presbyterian Healthcare Services CurrentSince Sep 5, 2017 Accepting new patients
St. Vincent Hospital CurrentSince Nov 14, 2022 Accepting new patients
St Vincent Hospital Obstetrics & Gynecology CurrentSince Nov 14, 2022 Accepting new patients
St Vincent Hospital Current Accepting new patients

Locations

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

1622 Galisteo St
Ste 200
Santa Fe, NM 87505
Phone (214) 500-0174

454 Saint Michaels Dr
Santa Fe, NM 87505
Phone (505) 303-5000

465 Saint Michaels Dr
Ste 200
Santa Fe, NM 87505
Phone (505) 995-4901

Interoperability endpoints

  • Direct secure messaging: wbrown297249@christushealth.direct-ci.net

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492646400000",
    "number": "1639295181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "546 HARKLE RD",
            "address_2": "SUITE A",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054784",
            "telephone_number": "505-983-6467",
            "fax_number": "505-983-2715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "546 HARKLE RD",
            "address_2": "SUITE A",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054784",
            "telephone_number": "505-983-6467",
            "fax_number": "505-983-2715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "D",
        "middle_name": "WILLIAM",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2017-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NM",
            "license": "84153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP",
            "identifier": "201001168",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID",
            "identifier": "00NM000453",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33621",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEIN",
            "identifier": "850344938",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

Verify at the official NPI Registry.