Joan Icilda Brown

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

RN177358 Issued in GA

Practice address

3341 Meadovista Dr
Ellenwood, GA 30294-6638

Phone

(917) 843-8386

NPI assigned

Dec 17, 2018

Last updated

Dec 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Joan Icilda Brown Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: joan.brown.1@32512.direct.athenahealth.com

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.

• Vera Whole Health Wa PC

  dba Vera Whole Health

  • Primary Care Clinic/Center
  • Decatur, GA
  • NPI 1669156881
  NPD (past)

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

{
    "created_epoch": "1545004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545004800000",
    "number": "1912478868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3341 MEADOVISTA DR",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302946638",
            "telephone_number": "917-843-8386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3341 MEADOVISTA DR",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302946638",
            "telephone_number": "917-843-8386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JOAN",
        "middle_name": "ICILDA",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-17",
        "last_updated": "2018-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN177358",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "GA",
            "license": "RN177358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOAN",
            "last_name": "BROWN",
            "middle_name": "ICILDA",
            "credential": "FNP-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Melody Lawanda Bray-Ross, MD
• Latida Brooks, REGISTERED NURSE
• Brotherly Non-Medical Transport
• Michelle D Broussard, PHD, RDN, LD
• Eleanor Louise Brown, LPC
• Latoya Sophia Brown, RBT
• Toya Butler, MA, SLP
• C. Louise LLC
• C. V. Clopton, Jr, MD, PC (Clopton Primary Care)
• Claudine Caesar, FNP-BC

• Primary Care Nurse Practitioner in Ellenwood, GA
• Providers in Ellenwood, GA by specialty
• Primary Care Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.