Individual provider Active NPI

Bridget Marie Brown, M.D.

  • Pediatrics Physician
  • Loveland, CO
National Provider Identifier
1639353485
Registry record updated May 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
47521 Issued in CO
Practice address
3520 E 15TH St
Loveland, CO 80538-8938
Phone
(970) 313-2700
Fax
(970) 669-7521
NPI assigned
Dec 27, 2007
Last updated
May 5, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 6805153 UT
Pediatrics Physician 208000000X 47521 CO Primary

Addresses

Primary practice location

3520 E 15TH St
Loveland, CO 80538-8938

Mailing address

2555 E 13TH St
Suite 130
Loveland, CO 80537-5161
Phone (970) 663-5437

Other identifiers 1

IdentifierTypeStateIssuer
93451385MedicaidCO

Other names 1

  • Bridget Marie Jackson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20090707000213 CO Practitioner - Pediatric Medicine 0244381143 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
47521COMDPediatrics Physician
6805153UTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Aug 28, 2017 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Aug 28, 2017 Accepting new patients
Big Thompson Medical Group Inc Pediatrics Past Accepting new patients
Medical Center of the Rockies Past Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

2500 Rocky Mountain Ave
Ste 330
Loveland, CO 80538
Phone (970) 203-7110

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2403

3520 E 15th St
Loveland, CO 80538
Phone (970) 313-2700

3520 E 15th St
Ste 201
Loveland, CO 80538
Phone (970) 203-7165

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588636800000",
    "number": "1639353485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 E 13TH ST",
            "address_2": "SUITE 130",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805375161",
            "telephone_number": "970-663-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 E 15TH ST",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805388938",
            "telephone_number": "970-313-2700",
            "fax_number": "970-669-7521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "BRIDGET",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-27",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "UT",
            "license": "6805153",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "47521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "93451385",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIDGET",
            "last_name": "JACKSON",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Loveland, CO

Sources for this page

Verify at the official NPI Registry.