Individual provider Active NPI

Jenny L Brown

  • Medical Physician Assistant
  • Beulah, ND
National Provider Identifier
1891355608
Registry record updated May 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
1312 Highway 49 N
Beulah, ND 58523-6038
Phone
(701) 873-4445
NPI assigned
Jun 14, 2019
Last updated
May 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X NU Primary

Addresses

Primary practice location

1312 Highway 49 N
Beulah, ND 58523-6038

Mailing address

1312 Highway 49 N
Beulah, ND 58523-6038
Phone (701) 873-4445

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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
I20200113000220 ND Practitioner - Physician Assistant 9638504103 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1312 Hwy 49 N
Beulah, ND 58523-6038
Phone (701) 873-4445

510 8TH Ave NE
Hazen, ND 58545-4637
Phone (701) 748-2256

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hazen Memorial Hospital Association CurrentSince Apr 28, 2022 Accepting new patients
Coal Country Community Health Center CurrentSince Jan 17, 2022 Accepting new patients
Hazen Memorial Hospital Association CurrentSince Apr 28, 2022 Accepting new patients
Coal Country Community Health Center CurrentSince Jan 17, 2022 Accepting new patients

Locations

1312 Highway 49 N
Beulah, ND 58523
Phone (701) 873-4445

510 8th Ave NE
Hazen, ND 58545
Phone (701) 748-2225

220 4th Ave SW
Killdeer, ND 58640
Phone (701) 764-5093

Organizations & group practices 6

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 3

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": "1560470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683763200000",
    "number": "1891355608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1312 HIGHWAY 49 N",
            "city": "BEULAH",
            "state": "ND",
            "postal_code": "585236038",
            "telephone_number": "701-873-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 HIGHWAY 49 N",
            "city": "BEULAH",
            "state": "ND",
            "postal_code": "585236038",
            "telephone_number": "701-873-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JENNY",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-14",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beulah, ND

Sources for this page

Verify at the official NPI Registry.