Individual provider Active NPI

Stephen Romen Brown, M.D.

  • Gynecology Physician
  • Texarkana, TX
National Provider Identifier
1710986930
Registry record updated Apr 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
G-6478 Issued in TX
Practice address
2006 Moores Lane
Texarkana, TX 75503-1840
Phone
(903) 792-6944
Fax
(903) 792-6213
NPI assigned
Jul 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X G-6478 TX Primary

Addresses

Primary practice location

2006 Moores Lane
Texarkana, TX 75503-1840

Mailing address

919 Hidden RDG
FL 6
Irving, TX 75038-3813
Phone (469) 282-2713

Other identifiers 2

IdentifierTypeStateIssuer
033078902MedicaidTX
200966610AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20050622000527 TX Practitioner - Obstetrics/Gynecology 5092750067 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G-6478TXMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas Gynecology CurrentSince Jul 1, 2017 Accepting new patients
C H Wilkinson Physician Network CurrentSince Jan 5, 2015 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jul 1, 2017 Accepting new patients
C H Wilkinson Physician Network CurrentSince Jan 5, 2015 Accepting new patients

Locations

919 Hidden Rdg
Fl 6
Irving, TX 75038
Phone (469) 282-2711

1276 S Peachtree St
Jasper, TX 75951
Phone (409) 384-5701

2006 Moores Ln
Ste B
Texarkana, TX 75503
Phone (903) 792-6944

2006 Moores Ln
Texarkana, TX 75503
Phone (903) 792-6944

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/996/brand/1/csg/213/fhir/r4
  • Direct secure messaging: sbrown226140@christushealth.direct-ci.net

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1710986930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 HIDDEN RDG",
            "address_2": "FL 6",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750383813",
            "telephone_number": "469-282-2713",
            "fax_number": "469-282-2609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2006 MOORES LANE",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755031840",
            "telephone_number": "903-792-6944",
            "fax_number": "903-792-6213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "STEPHEN",
        "middle_name": "ROMEN",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "TX",
            "license": "G-6478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "033078902",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200966610A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

Verify at the official NPI Registry.