Marlin Lavar Brown, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT002838 Issued in GA

Practice address

110 Professional CT
Jesup, GA 31545-0044

Phone

(912) 427-0800

Fax

(912) 427-6029

NPI assigned

Jul 12, 2012

Sex

Male

Sole proprietor

No

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

State licenses

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

{
    "created_epoch": "1342051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482451200000",
    "number": "1710242961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1334",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315981334",
            "telephone_number": "843-412-8761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 PROFESSIONAL CT",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315450044",
            "telephone_number": "912-427-0800",
            "fax_number": "912-427-6029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "MARLIN",
        "middle_name": "LAVAR",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-12",
        "last_updated": "2016-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "AT002838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bone and Joint Institute of South Georgia, P.C.
• Lindsey D Bookhardt, P.A.
• Amelia Sheehan Bostwick, M.D.
• Kelly Boyette, FNP
• Brandi J Brown
• Melody Dempsey Brown, R.N.
• Diane Bruce, OD
• Lafayette Burks, MD
• Mark D Byron, MD
• Stacey N Cain

• All providers in Jesup, GA
• Athletic Trainer in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2016; 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.