NPIMap

Individual provider Active NPI

Jeremy Ronald Brown, D.O.

  • Family Medicine Physician
  • Colorado Springs, CO
National Provider Identifier
1912212093
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
51197 Issued in CO
Practice address
5715 Kittery Dr
Colorado Springs, CO 80911-3551
Phone
(719) 392-3883
Fax
(719) 390-6338
NPI assigned
Aug 12, 2010
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 51197 CO Primary

Addresses

Primary practice location

5715 Kittery Dr
Colorado Springs, CO 80911-3551

Mailing address

5715 Kittery Dr
Colorado Springs, CO 80911-3551
Phone (719) 392-3883

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131007000868 CO Practitioner - Family Practice 5496989410 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Kansas City University of Physicians and Surgeons, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ripley R Hollister MD PCGroup PAC ID 7810113750, 4 clinicians

Practice addresses (Care Compare)

2855 Dublin Blvd
Colorado Springs, CO 80918-1662
Phone (719) 265-6464

5715 Kittery Dr
Colorado Springs, CO 80911-3551
Phone (719) 392-3883

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
27.78 of 100Reported as individual
Quality
15
Improvement activities
0
Cost
72.59

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51197COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ripley R. Hollister, M.D. P.C. CurrentSince Aug 11, 2014 Accepting new patients
Dynamic Family Medicine PLLC Family Medicine CurrentSince Jun 14, 2017 Accepting new patients
Primary Care Physicians, P.C. Family Medicine PastSince May 1, 1997 Accepting new patients
Woodland Park Surgical Associates, P.C. PastSince Oct 1, 2016 Accepting new patients

Locations

5715 Kittery Dr
Colorado Springs, CO 80911
Phone (719) 390-6338

2855 Dublin Blvd
Colorado Springs, CO 80918
Phone (719) 265-1902

2855 Dublin Blvd
#T
Colorado Springs, CO 80918
Phone (719) 265-6464

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 4

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 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1281571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1912212093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5715 KITTERY DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809113551",
            "telephone_number": "719-392-3883",
            "fax_number": "719-390-6338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5715 KITTERY DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809113551",
            "telephone_number": "719-392-3883",
            "fax_number": "719-390-6338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JEREMY",
        "middle_name": "RONALD",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-12",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "51197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.