Active NPI
Jody Lane Brown, M.D.
- Child & Adolescent Psychiatry Physician
- Gainesville, FL
National Provider Identifier
1689660441
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- ME 83675
- Practice address
- 4300 SW 13TH St
Gainesville, FL 32608-4006 - Phone
- (352) 374-5600
- NPI assigned
- Sep 27, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | ME 83675 | FL | Primary |
| Child & Adolescent Psychiatry Physician | 2084P0804X | E-6072 | AR | |
| Psychiatry Physician | 2084P0800X | E-6072 | AR |
Addresses
Primary practice location
4300 SW 13TH St
Gainesville, FL 32608-4006
Mailing address
4300 SW 13TH St
Gainesville, FL 32608-4006
Phone (352) 374-5600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 281278900 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME 83675 | FL | MD | Child & Adolescent Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Clinical Practice Association Inc | Current | Accepting new patients | |
| Florida Clinical Practice Association Inc | Current | Accepting new patients |
Locations
303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285
2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990
1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077
Interoperability endpoints
- jbrown164338@direct.shands.ufl.edu
Organizations & group practices 2
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.
-
- Surgery Physician
- Gainesville, FL
- NPI 1063463768
-
- Durable Medical Equipment & Medical Supplies
- Ocala, FL
- NPI 1609529478
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421625600000",
"number": "1689660441",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4300 SW 13TH ST",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326084006",
"telephone_number": "352-374-5600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4300 SW 13TH ST",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326084006",
"telephone_number": "352-374-5600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "JODY",
"middle_name": "LANE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-27",
"last_updated": "2015-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "FL",
"license": "ME 83675",
"primary": true
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "AR",
"license": "E-6072",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "AR",
"license": "E-6072",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "281278900",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2015; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.