Individual provider Active NPI

Jordan Michael Brown, MD

  • Diagnostic Radiology Physician
  • Saint Louis, MO
National Provider Identifier
1891089223
Registry record updated Sep 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2016010901 Issued in MO
Practice address
6607 Clayton Rd Apt 2W
Saint Louis, MO 63117-1640
Phone
(314) 991-8200
NPI assigned
Jun 2, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 0446268 KS
Diagnostic Radiology Physician 2085R0202X 036149307 IL
Diagnostic Radiology Physician 2085R0202X 01082252A IN
Diagnostic Radiology Physician 2085R0202X 2016010901 MO Primary

Addresses

Primary practice location

6607 Clayton Rd Apt 2W
Saint Louis, MO 63117-1640

Mailing address

11475 Olde Cabin Rd Ste 200
Saint Louis, MO 63141-7129
Phone (314) 991-8200

Other practice location 1

100 Mercy Way
Joplin, MO 64804-4524
Phone (417) 556-4762

Other practice location 2

3125 Dr Russell Smith Way
Carthage, MO 64836-7402
Phone (417) 359-1320

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20160512001282 MO Practitioner - Diagnostic Radiology 4880904275 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Missouri, Columbia School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West County Radiological Group IncGroup PAC ID 8527966944, 105 clinicians

Practice addresses (Care Compare)

10010 Kennerly Rd
Saint Louis, MO 63128-2106
Phone (314) 525-1165

1400 US Hwy 61
Festus, MO 63028-4100
Phone (636) 933-1055

615 S New Ballas Rd
Saint Louis, MO 63141-8221
Phone (314) 251-6031

6607 Clayton Rd
Saint Louis, MO 63117-1609
Phone (314) 941-5600

901 E 5TH St
Washington, MO 63090-3127
Phone (636) 239-8250

901 Patients 1St Dr
Washington, MO 63090-4700
Phone (636) 231-6252

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.77 of 100Reported as group
Quality
86.95
Improvement activities
40
Cost
73.15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036149307ILMDDiagnostic Radiology Physician
01082252AINMDDiagnostic Radiology Physician
0446268KSMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Springfield Clinic LLP Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jordanbrown@sfc.allscriptsdirect.net

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.

Hospital & facility affiliations 6

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": "1306972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1891089223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11475 OLDE CABIN RD STE 200",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631417129",
            "telephone_number": "314-991-8200",
            "fax_number": "314-569-1787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6607 CLAYTON RD APT 2W",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631171640",
            "telephone_number": "314-991-8200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Mercy Way",
            "address_purpose": "LOCATION",
            "city": "Joplin",
            "state": "MO",
            "postal_code": "648044524",
            "country_code": "US",
            "telephone_number": "417-556-4762",
            "fax_number": "417-556-6321",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3125 Dr Russell Smith Way",
            "address_purpose": "LOCATION",
            "city": "Carthage",
            "state": "MO",
            "postal_code": "648367402",
            "country_code": "US",
            "telephone_number": "417-359-1320",
            "fax_number": "417-237-7283",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JORDAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-02",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KS",
            "license": "0446268",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036149307",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01082252A",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2016010901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.