Jennifer Lynn Brown, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2265 Issued in AR

Practice address

1717 Industrial Dr
Fordyce, AR 71742-7104

Phone

(870) 352-7975

Fax

(870) 352-8163

NPI assigned

Aug 31, 2009

Last updated

Aug 31, 2009By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Practice roles

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.

• First Step, Inc.

  dba Park Place 1 Group Home, Park Place 2 Group Home

  • Developmentally Disabled Services Day Training Agency
  • Hot Springs, AR
  • NPI 1922157403
  NPD (past)

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

{
    "created_epoch": "1251676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251676800000",
    "number": "1740413384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 BREWSTER ST",
            "city": "FORDYCE",
            "state": "AR",
            "postal_code": "717422802",
            "telephone_number": "870-884-0018",
            "fax_number": "870-325-6316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 INDUSTRIAL DR",
            "city": "FORDYCE",
            "state": "AR",
            "postal_code": "717427104",
            "telephone_number": "870-352-7975",
            "fax_number": "870-352-8163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-31",
        "last_updated": "2009-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AR",
            "license": "2265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cherie Ann Bonanno, MHPP
• Kristen F Boren, MHPP
• Leslie Brandon, LPC
• Barry Bray, MHPP
• Donald Todd Brown, MHPP
• Stacey Brunson, MHPP
• Daniel Nathan Bryant, PHARMD
• Jenna Bryant, APRN
• Tavante Calhoun, MHPP
• Amber Callaway, LPC

• Physical Therapy Assistant in Fordyce, AR
• Providers in Fordyce, AR by specialty
• Physical Therapy Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2009; 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.