Individual provider Active NPI

Blair Jordon Brown, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Winston Salem, NC
National Provider Identifier
1861874539
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
2020-03619 Issued in NC
Practice address
3001 Lyndhurst Ave
Winston Salem, NC 27103-4026
Phone
(336) 765-0383
NPI assigned
Jun 18, 2015
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 209949 NC
Internal Medicine Physician 207R00000X 209949 NC
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 2020-03619 NC Primary

Addresses

Primary practice location

3001 Lyndhurst Ave
Winston Salem, NC 27103-4026

Mailing address

5172 Old Plantation Cir
Winston Salem, NC 27104-4410
Phone (828) 244-5592

Other practice location 1

1 Medical Center Blvd
Winston-Salem, NC 27103
Phone (336) 716-2011

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address brown012181@direct.novanthealth.org Direct Spectrum Medical Group PA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20210324001714 NC Practitioner - Critical Care (Intensivists)Practitioner - Internal Medicine 1355659293 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spectrum Medical Group PAGroup PAC ID 1254234388, 15 clinicians
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

3001 Lyndhurst Ave
Winston Salem, NC 27103-4007
Phone (336) 765-0383

3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone (336) 718-7597

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209949NCMDInternal Medicine Physician
2020-03619NCMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Critical Care Medicine CurrentSince Sep 1, 2021 Accepting new patients
Novant Health Medical Group, LLC Single Specialty Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Sep 1, 2021 Accepting new patients
Spectrum Medical Group PA Single Specialty CurrentSince Dec 18, 2020 Accepting new patients
Novant Health Medical Group, LLC Single Specialty Past Accepting new patients

Locations

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

3001 Lyndhurst Ave
Winston Salem, NC 27103
Phone (336) 765-0383

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

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.

Hospital & facility affiliations 4

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": "1434585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1861874539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5172 OLD PLANTATION CIR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271044410",
            "telephone_number": "828-244-5592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 LYNDHURST AVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034026",
            "telephone_number": "336-765-0383"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Winston-Salem",
            "state": "NC",
            "postal_code": "27103",
            "country_code": "US",
            "telephone_number": "336-716-2011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "BLAIR",
        "middle_name": "JORDON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-18",
        "last_updated": "2023-11-27",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "209949",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "209949",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NC",
            "license": "2020-03619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brown012181@direct.novanthealth.org",
            "affiliation": "Y",
            "affiliationName": "Spectrum Medical Group PA",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3001 Lyndhurst Ave",
            "city": "Winston-Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271034007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.