Individual provider Active NPI

Jackson Brown, M.S.

  • Counselor
  • Memphis, TN
National Provider Identifier
1942577119
Registry record updated Nov 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
20-3858944 Issued in TN
Practice address
5118 Park Ave
Suite 500
Memphis, TN 38117-5720
Phone
(901) 458-8638
NPI assigned
Nov 16, 2011
Last updated
Nov 16, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 20-3858944 TN Primary

Addresses

Primary practice location

5118 Park Ave
Suite 500
Memphis, TN 38117-5720

Mailing address

790 Homer St
Memphis, TN 38122-3404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
20-3858944TNMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1321401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321401600000",
    "number": "1942577119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 HOMER ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381223404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5118 PARK AVE",
            "address_2": "SUITE 500",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381175720",
            "telephone_number": "901-458-8638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JACKSON",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-16",
        "last_updated": "2011-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TN",
            "license": "20-3858944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2011; 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.