Kenneth Brown Jr., N/A

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

310 Mid Continent PLZ Ste 616
West Memphis, AR 72301-1760

Phone

(870) 394-9711

NPI assigned

Jan 29, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Elevated Healthcare Services LLC

  • In Home Supportive Care Agency
  • West Memphis, AR
  • NPI 1821819285
  NPD

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

{
    "created_epoch": "1706486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1679335152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 63",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723030063",
            "telephone_number": "870-394-9711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 MID CONTINENT PLZ STE 616",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723011760",
            "telephone_number": "870-394-9711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "KENNETH",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "N/A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-01-29",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Broadway Health and Rehab, LLC
• Broadway Health Holdings LLC
• Dorothy M Broadway, CNA
• Marcus Brooks, MHPP
• Jillian Brown, PHARMD
• Marquitta C Brown, MHPP
• Michael Brown
• Roland R Brown, MD
• Sabrina Brown
• Taylor Hotz Brown

• Student in an Organized Health Care Education/Training Program in West Memphis, AR
• Providers in West Memphis, AR by specialty
• Student in an Organized Health Care Education/Training Program in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; 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.