Individual provider Active NPI

Shari L Brown, M.D.

  • Molecular Genetic Pathology (Pathology) Physician
  • Fort Myers, FL
National Provider Identifier
1720241813
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Molecular Genetic Pathology (Pathology) PhysicianTaxonomy code 207ZP0007X
License
ME142588 Issued in FL
Practice address
12701 Commonwealth Dr Ste 9
Fort Myers, FL 33913-8626
Phone
(866) 776-5907
Fax
(239) 690-4237
NPI assigned
Jul 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X ME142588 FL
Molecular Genetic Pathology (Pathology) Physician 207ZP0007X ME142588 FL Primary

Addresses

Primary practice location

12701 Commonwealth Dr Ste 9
Fort Myers, FL 33913-8626

Mailing address

12701 Commonwealth Dr Ste 9
Fort Myers, FL 33913-8626
Phone (866) 776-5907

Other identifiers 2

IdentifierTypeStateIssuer
1720241813MedicaidNC
19CRBOtherNCBCBS NC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME142588FLMDAnatomic Pathology & Clinical Pathology Physician

Interoperability endpoints

  • Direct secure messaging: sbrown133365@capefearvalley.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1720241813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12701 COMMONWEALTH DR STE 9",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339138626",
            "telephone_number": "866-776-5907",
            "fax_number": "239-690-4237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12701 COMMONWEALTH DR STE 9",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339138626",
            "telephone_number": "866-776-5907",
            "fax_number": "239-690-4237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "SHARI",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-08",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "ME142588",
            "primary": false
        },
        {
            "code": "207ZP0007X",
            "taxonomy_group": "",
            "desc": "Pathology, Molecular Genetic Pathology",
            "state": "FL",
            "license": "ME142588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720241813",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "19CRB",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; 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.