Jennifer Kay Brown, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

21724 Issued in CA

Practice address

721 River Drive
Suite B
Fort Bragg, CA 95437

Phone

(707) 964-6910

Fax

(707) 964-7430

NPI assigned

Jun 30, 2006

Last updated

Dec 1, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Ms. Jennifer Kay White Former name

Medicare fee-for-service enrollment

Enrolled in TX, CA, NM3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Physician Assistant

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Adventist Health Mendocino CoastGroup PAC ID 3678990769, 57 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventist Health Mendocino Coast Hospital, Fort Bragg, CA, CCN 051325
• Adventist Health Howard Memorial Hospital, Willits, CA, CCN 051310

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jbrown150995@direct.renown.org

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.

• Adventist Health Mendocino Coast

  dba Mendocino Coast District Hospital

  • Critical Access Hospital
  • Fort Bragg, CA
  • NPI 1538113725
  Medicare reassignment Care Compare group
• DHHS, PHS, Naihs, Shiprock Hospital

  dba Northern Navajo Medical Center

  • General Acute Care Hospital
  • Shiprock, NM
  • NPI 1780639971

  TX

  Medicare reassignment NPD
• Rehoboth McKinley Christian Health Care Services, Inc

  • Critical Access Hospital
  • Gallup, NM
  • NPI 1689784506
  Medicare reassignment NPD
• Adventist Health Physicians Network

  • Multi-Specialty Clinic/Center
  • Hanford, CA
  • NPI 1063718583
  Medicare reassignment
• Adventist Health Physicians Network

  • Cardiovascular Disease Physician
  • Clearlake, CA
  • NPI 1992242614
  NPD
• DHHS, PHS, Naihs, Shiprock Hospital

  • General Acute Care Hospital
  • Teec Nos Pos, AZ
  • NPI 1477615789
  NPD
• Rehoboth McKinley Christian Health Care Services, Inc

  dba Red Rock Clinic

  • Surgery Physician
  • Gallup, NM
  • NPI 1558829556
  NPD
• Rehoboth McKinley Christian Health Care Services, Inc

  • Rural Health Clinic/Center
  • Gallup, NM
  • NPI 1689779860
  NPD
• Theophil Jantz, D.O., Inc

  • Surgery Physician
  • Fort Bragg, CA
  • NPI 1902017932
  NPD (past)

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

• Adventist Health Mendocino Coast

  dba Mendocino Coast District Hospital

  • Critical Access Hospital
  • Fort Bragg, CA
  • NPI 1538113725
  Care Compare affiliation
• Willits Hospital Inc.

  dba Adventist Health Howard Memorial

  • Critical Access Hospital
  • Willits, CA
  • NPI 1356339543
  Care Compare affiliation

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1689603128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 RIVER DRIVE",
            "address_2": "SUITE B",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "95437",
            "telephone_number": "707-964-6910",
            "fax_number": "707-964-7430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 RIVER DRIVE",
            "address_2": "SUITE B",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "95437",
            "telephone_number": "707-964-6910",
            "fax_number": "707-964-7430"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "260 Hospital Dr Ste 107",
            "address_purpose": "LOCATION",
            "city": "Ukiah",
            "state": "CA",
            "postal_code": "954824568",
            "country_code": "US",
            "telephone_number": "707-467-5278",
            "fax_number": "707-463-7373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JENNIFER",
        "middle_name": "KAY",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2023-12-01",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA20140017",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "HI",
            "license": "AMD-278",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "21724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "WHITE",
            "middle_name": "KAY",
            "prefix": "MS.",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physician Assistant in Fort Bragg, CA
• Providers in Fort Bragg, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.