Individual provider Active NPI

Kelly Michelle Brown, PA-C

  • Surgical Physician Assistant
  • Houston, TX
National Provider Identifier
1952397291
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA08669 Issued in TX
Practice address
6410 Fannin St Ste 350
Houston, TX 77030-3004
Phone
(713) 242-2366
NPI assigned
Sep 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA08669 TX Primary

Addresses

Primary practice location

6410 Fannin St Ste 350
Houston, TX 77030-3004

Mailing address

6431 Fannin St # 3.286
Houston, TX 77030-1501
Phone (713) 242-2366

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
I20130926000585 TX Practitioner - Physician Assistant 5395708986 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA08669TXMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians CurrentSince Sep 1, 2013 Accepting new patients
Ut Physicians CurrentSince Sep 1, 2013 Accepting new patients
Henry Ford Health St. John Hospital Past Accepting new patients

Locations

6700 West Loop S
Ste 450
Bellaire, TX 77401
Phone (713) 486-9300

6410 Fannin St
Ste 350
Houston, TX 77030
Phone (832) 325-7200

6431 Fannin St
#3286
Houston, TX 77030
Phone (713) 500-7780

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

929 Gessner Rd
Houston, TX 77024
Phone (713) 242-3650

6410 Fannin St
Ste 250
Houston, TX 77030
Phone (713) 500-4360

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1952397291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6431 FANNIN ST # 3.286",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301501",
            "telephone_number": "713-242-2366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 FANNIN ST STE 350",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770303004",
            "telephone_number": "713-242-2366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "KELLY",
        "middle_name": "MICHELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-22",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA08669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.