Individual provider Active NPI

Justin Brown, NP

  • Family Nurse Practitioner
  • Clarksville, TX
National Provider Identifier
1912468109
Registry record updated Oct 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
78818 Issued in KS
Practice address
201 S Walnut St
Clarksville, TX 75426-3737
Phone
(903) 427-5682
NPI assigned
Mar 29, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Nurse Practitioner 363LF0000X 78818 KS Primary

Addresses

Primary practice location

201 S Walnut St
Clarksville, TX 75426-3737

Mailing address

201 S Walnut St
Clarksville, TX 75426-3737
Phone (903) 428-5682

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20211101001468 TX Practitioner - Nurse Practitioner 5597092502 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PRMC Healthcare Group, Inc.Group PAC ID 6406919901, 41 clinicians

Practice addresses (Care Compare)

201 S Walnut St
Clarksville, TX 75426-3737
Phone (903) 427-5682

2850 Lewis LN
Paris, TX 75460-9378

2870 Lewis LN
Paris, TX 75460-9380

865 Deshong Dr
Paris, TX 75460-9313
Phone (903) 737-1111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
78818KSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Essent PRMC LP Current Accepting new patients
PRMC Healthcare Group Inc CurrentSince Nov 1, 2021 Accepting new patients
Essent PRMC LP CurrentSince Jan 15, 2024 Accepting new patients
PRMC Healthcare Group Inc CurrentSince Nov 1, 2021 Accepting new patients
Essent PRMC LP CurrentSince Jan 15, 2024 Accepting new patients

Locations

201 S Walnut St
Clarksville, TX 75426
Phone (903) 427-5682

2224 Bonham St
Paris, TX 75460
Phone (903) 739-2299

865 Deshong Dr
Paris, TX 75460
Phone (903) 731-1111

820 Clarksville St
Paris, TX 75460
Phone (903) 737-3291

2870 Lewis Ln
Ste 220
Paris, TX 75460
Phone (903) 739-7830

Interoperability endpoints

  • Direct secure messaging: justin.brown.1@1744.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/fhir/r4

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1912468109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 S WALNUT ST",
            "city": "CLARKSVILLE",
            "state": "TX",
            "postal_code": "754263737",
            "telephone_number": "903-428-5682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S WALNUT ST",
            "city": "CLARKSVILLE",
            "state": "TX",
            "postal_code": "754263737",
            "telephone_number": "903-427-5682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JUSTIN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-29",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "78818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TX

Sources for this page

Verify at the official NPI Registry.