Individual provider Active NPI

Larae Coleman Brown, MD

  • Obstetrics & Gynecology Physician
  • Jacksonville, FL
National Provider Identifier
1780851980
Registry record updated Sep 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME112367 Issued in FL
Practice address
15255 Max Leggett Pkwy Ste 4400
Jacksonville, FL 32218-7273
Phone
(904) 427-8898
Fax
(904) 383-1893
NPI assigned
May 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X TRN12325 FL
Obstetrics & Gynecology Physician 207V00000X ME112367 FL Primary

Addresses

Primary practice location

15255 Max Leggett Pkwy Ste 4400
Jacksonville, FL 32218-7273

Mailing address

15255 Max Leggett Pkwy Ste 4400
Jacksonville, FL 32218-7273
Phone (904) 427-8898

Other identifiers 2

IdentifierTypeStateIssuer
005839000MedicaidFL
003124700AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20120622000303 FL Practitioner - Obstetrics/Gynecology 7113182247 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Florida College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Florida Jacksonville Physicians, Inc.Group PAC ID 9133025869, 908 clinicians

Practice addresses (Care Compare)

653 W 8TH St
Jacksonville, FL 32209-6511
Phone (904) 244-7874

655 W 8TH St
Jacksonville, FL 32209-6511
Phone (904) 244-7874

76011 William Burgess Rd
Yulee, FL 32097-5428
Phone (904) 427-8590

Hospital & facility affiliations

  • Shands Jacksonville Hospital, Jacksonville, FL, CCN 100001

Merit-based Incentive Payment System (MIPS)

Final score
59.59 of 100Reported as apm
Quality
59.93
Promoting interoperability
0
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TRN12325FLMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians Inc Current Accepting new patients
University of Florida Jacksonville Physicians, Inc. Obstetrics & Gynecology PastSince Sep 23, 2021 Accepting new patients

Locations

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

76011 William Burgess Blvd
Fl 2
Yulee, FL 32097

Interoperability endpoints

  • Direct secure messaging: lbrown37492@direct.shands.ufl.edu

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Uf Health Jacksonville Home CareJacksonville, FL, CCN 107125 Home health agency Corporate Director Sep 21, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631491200000",
    "number": "1780851980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15255 MAX LEGGETT PKWY STE 4400",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322187273",
            "telephone_number": "904-427-8898",
            "fax_number": "904-383-1893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15255 MAX LEGGETT PKWY STE 4400",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322187273",
            "telephone_number": "904-427-8898",
            "fax_number": "904-383-1893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "LARAE",
        "middle_name": "COLEMAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-15",
        "last_updated": "2021-09-13",
        "certification_date": "2021-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "TRN12325",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME112367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005839000",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003124700A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.