Individual provider Active NPI

Justin Ryan Brown, D.O.

  • Internal Medicine Physician
  • Aransas Pass, TX
National Provider Identifier
1740504695
Registry record updated Sep 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
N5594 Issued in TX
Practice address
1711 W Wheeler Ave
Aransas Pass, TX 78336-4536
Phone
(361) 758-8585
NPI assigned
Mar 22, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X N5594 TX
Internal Medicine Physician 207R00000X N5594 TX Primary

Addresses

Primary practice location

1711 W Wheeler Ave
Aransas Pass, TX 78336-4536

Mailing address

1802 Ennis Joslin Rd Apt 236
Corpus Christi, TX 78412-4340
Phone (702) 286-1030

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
I20100802001000 TX Practitioner - Emergency MedicinePractitioner - Internal Medicine 7719010446 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Victoria Emergency Associates LLC Emergency Medicine CurrentSince Oct 21, 2012 Accepting new patients
Texas Emergency Room Services, PA Emergency Medicine Past Accepting new patients
USA Emergency Centers - Clear Lake, LLC Past Accepting new patients
Oceanwind ER SVCS Partnership LLC Emergency Medicine Past Accepting new patients
Advanced Medical Care P.a. Internal Medicine Past Accepting new patients

Locations

506 E San Antonio St
Victoria, TX 77901
Phone (361) 575-1445

Organizations & group practices 5

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": "1269216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316995200000",
    "number": "1740504695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 ENNIS JOSLIN RD APT 236",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784124340",
            "telephone_number": "702-286-1030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 W WHEELER AVE",
            "city": "ARANSAS PASS",
            "state": "TX",
            "postal_code": "783364536",
            "telephone_number": "361-758-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JUSTIN",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-22",
        "last_updated": "2011-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "N5594",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "N5594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aransas Pass, TX

Sources for this page

Verify at the official NPI Registry.