Kenneth C. Brown, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

22959 Issued in AL

Practice address

126 Clinic Dr
Dothan, AL 36303-1980

Phone

(334) 793-1881

Fax

(334) 712-1815

NPI assigned

Oct 31, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kennethbrown@dpc.allscriptsdirect.net

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.

• Dothan Pediatric Clinic, P. a.

  • Pediatrics Physician
  • Dothan, AL
  • NPI 1376508788
  Medicare reassignment NPD

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462838400000",
    "number": "1891786844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 CLINIC DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363031980",
            "telephone_number": "334-793-1881",
            "fax_number": "334-712-1815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 CLINIC DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363031980",
            "telephone_number": "334-793-1881",
            "fax_number": "334-712-1815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "KENNETH",
        "middle_name": "C.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2016-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AL",
            "license": "22959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000039493",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allexius Bronner
• Richard Reginald Brookins, LPC
• Simon Roland Brooks, M.D
• Nikki Ilona Broussard, CRNP
• Alybelle Axie Brown
• Kyle Darren Brown, DOCTOR OF PHARMACY
• Tiffany Brown, LMT
• Isabella Browning
• Susan Elaine Broyles, CRNP
• Courtney Brue, PMHNP

• Pediatrics Physician in Dothan, AL
• Providers in Dothan, AL by specialty
• Pediatrics Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.