Individual provider Active NPI

Andrea Brown, NP-C

  • Family Nurse Practitioner
  • New Boston, TX
National Provider Identifier
1811653595
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1056892 Issued in TX
Practice address
3899 State Highway 98
New Boston, TX 75570-5669
Phone
(903) 628-3171
NPI assigned
Nov 16, 2021
Last updated
Jan 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1056892 TX Primary

Addresses

Primary practice location

3899 State Highway 98
New Boston, TX 75570-5669

Mailing address

3899 State Highway 98
New Boston, TX 75570-5669
Phone (903) 628-3171

Other identifiers 1

IdentifierTypeStateIssuer
1056892OtherTXTEXAS BOARD OF NURSING

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL unknown Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220222001375 TX Practitioner - Nurse Practitioner 2567856313

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1056892TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Larouge Personal Home Care, Inc. PastSince Nov 3, 2021 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1637020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1811653595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3899 STATE HIGHWAY 98",
            "city": "NEW BOSTON",
            "state": "TX",
            "postal_code": "755705669",
            "telephone_number": "903-628-3171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3899 STATE HIGHWAY 98",
            "city": "NEW BOSTON",
            "state": "TX",
            "postal_code": "755705669",
            "telephone_number": "903-628-3171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "ANDREA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-16",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1056892",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS BOARD OF NURSING",
            "identifier": "1056892",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "unknown",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "unknown",
            "address_1": "3899 State Highway 98",
            "city": "New Boston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "755705669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New Boston, TX

Sources for this page

Verify at the official NPI Registry.