Individual provider Active NPI

Lisa Brown, FNP-BC

  • Family Nurse Practitioner
  • Hagerstown, MD
National Provider Identifier
1821558164
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95011342 Issued in CA
Practice address
303 Memorial Blvd W
Hagerstown, MD 21740-6219
Phone
(013) 791-7060
Fax
(301) 791-8990
NPI assigned
Mar 22, 2019
Last updated
Jan 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 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 95011342 CA Primary

Addresses

Primary practice location

303 Memorial Blvd W
Hagerstown, MD 21740-6219

Mailing address

303 Memorial Blvd W
Hagerstown, MD 21740-6219
Phone (301) 791-7060

Other identifiers 1

IdentifierTypeStateIssuer
95011342OtherCACA BOARD OF REGISTERED NURSING

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220809001080 MD Practitioner - Nurse Practitioner 7911332911 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dej Med Practice, LLC CurrentSince Jul 1, 2022 Accepting new patients
Dej Med Practice, LLC Family Current Accepting new patients
Family Health Center of Joshua Tree, Inc. Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Coachella Desert Oasis OB/GYN, Medical Associates Inc. Past Accepting new patients

Locations

303 Memorial Blvd W
Hagerstown, MD 21740
Phone (301) 791-7060

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, 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": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1821558164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 MEMORIAL BLVD W",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217406219",
            "telephone_number": "301-791-7060",
            "fax_number": "301-791-8990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 MEMORIAL BLVD W",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217406219",
            "telephone_number": "013-791-7060",
            "fax_number": "301-791-8990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "LISA",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-22",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95011342",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA BOARD OF REGISTERED NURSING",
            "identifier": "95011342",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

Verify at the official NPI Registry.