Individual provider Active NPI

James Cornelius Brown II, PA-C

  • Physician Assistant
  • Lutz, FL
National Provider Identifier
1821295866
Registry record updated Oct 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9100900 Issued in FL
Practice address
24420 Sr 54
Lutz, FL 33559-7303
Phone
(813) 949-4100
Fax
(813) 949-4144
NPI assigned
Jul 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9100900 FL Primary

Addresses

Primary practice location

24420 Sr 54
Lutz, FL 33559-7303

Mailing address

918 Stallion Way
Valrico, FL 33594-4396
Phone (813) 546-6891

Other identifiers 1

IdentifierTypeStateIssuer
E2336QOtherFLMEDICARE PTAN LINKED TO GROUP PTAN GA609A

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2677GAMDOrthopedic Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke'S Methodist Hospital Current Accepting new patients
10 To 10 Urgent Care, LLC PastSince Aug 1, 2007 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jbrown264002@direct.unitypoint.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350864000000",
    "number": "1821295866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "918 STALLION WAY",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335944396",
            "telephone_number": "813-546-6891",
            "fax_number": "813-657-8893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24420 SR 54",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335597303",
            "telephone_number": "813-949-4100",
            "fax_number": "813-949-4144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JAMES",
        "middle_name": "CORNELIUS",
        "name_suffix": "II",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-02",
        "last_updated": "2012-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9100900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN LINKED TO GROUP PTAN GA609A",
            "identifier": "E2336Q",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutz, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; 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.