Ellen Marie Brown, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

2180 Main St
Wailuku, HI 96793-1625

Phone

(808) 242-4267

Fax

(808) 242-4292

NPI assigned

Apr 29, 2008

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 30, 2021.

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1790950806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5143",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288135143",
            "telephone_number": "808-495-5535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2180 MAIN ST",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967931625",
            "telephone_number": "808-242-4267",
            "fax_number": "808-242-4292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "ELLEN",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-29",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "22328",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "HI",
            "license": "AMD-519",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-001099",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Douglas Breithaupt, PH.D.
• Malte Breitlow, PHARMD.
• Michael Ross Brewer, D.P.M.
• Brian I. Watanabe, M.D., Inc.
• Alexandria Emilie Brito, CNM
• Evan G. Brown, DO
• Irving Brown, M.D.
• Jadine L. Brown, MPT
• Mark Brown, RPH, MBA
• Lucas Frank Bruno III, MA

• All providers in Wailuku, HI
• Physician Assistant in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.