Individual provider Active NPI

Karl Lorenzo Brown, M.D.

  • Internal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1649497702
Registry record updated Aug 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
12624 Issued in NV
Practice address
4700 Las Vegas Blvd N
Nellis AFB
Las Vegas, NV 89191-6600
Phone
(702) 653-3251
NPI assigned
Apr 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 23717 NE
Internal Medicine Physician 207R00000X 12624 NV Primary

Addresses

Primary practice location

4700 Las Vegas Blvd N
Nellis AFB
Las Vegas, NV 89191-6600

Mailing address

4700 Las Vegas Blvd N
Nellis AFB
Las Vegas, NV 89191-6600
Phone (702) 653-3251

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, ID2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100422000957 UT Practitioner - Internal Medicine 2769553387 Reassigns benefits to 1 organization
I20120726000018 ID Practitioner - Internal Medicine 2769553387 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23717NEMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Molina Healthcare of Utah Inc CurrentSince Mar 17, 2018 Accepting new patients
Molina Care Connections, LLC. CurrentSince May 1, 2018 Accepting new patients
Inpatient Consultants of Nevada, Inc. a Medical Corporation Internal Medicine Past Accepting new patients

Locations

200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666

950 W Bannock St
Ste 1100
Boise, ID 83702
Phone (201) 293-7689

7050 S Union Park Ave
Ste 200
Midvale, UT 84047
Phone (562) 549-3966

Interoperability endpoints

  • FHIR API: https://epicproxy.et1057.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 3

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": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218153600000",
    "number": "1649497702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 LAS VEGAS BLVD N",
            "address_2": "NELLIS AFB",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891916600",
            "telephone_number": "702-653-3251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 LAS VEGAS BLVD N",
            "address_2": "NELLIS AFB",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891916600",
            "telephone_number": "702-653-3251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "KARL",
        "middle_name": "LORENZO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2008-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "23717",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "12624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.