Active NPI
Frederick L Brown, DPM
- Podiatrist
- Medina, OH
National Provider Identifier
1962499699
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 36001409
- Practice address
- 535 E Smith Rd
Medina, OH 44256-2637 - Phone
- (330) 725-7075
- Fax
- (330) 725-3988
- NPI assigned
- Sep 27, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 36001409 | OH | Primary |
| Foot Surgery Podiatrist | 213ES0131X | 36001409 | OH |
Addresses
Primary practice location
535 E Smith Rd
Medina, OH 44256-2637
Mailing address
535 E Smith Rd
Medina, OH 44256-2637
Phone (330) 725-7075
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0267214 | Medicaid | OH | |
| 000000130372 | Other | OH | ANTHEM BCBS |
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36001409 | OH | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204761600000",
"number": "1962499699",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "535 E SMITH RD",
"city": "MEDINA",
"state": "OH",
"postal_code": "442562637",
"telephone_number": "330-725-7075",
"fax_number": "330-725-3988"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "535 E SMITH RD",
"city": "MEDINA",
"state": "OH",
"postal_code": "442562637",
"telephone_number": "330-725-7075",
"fax_number": "330-725-3988"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "FREDERICK",
"middle_name": "L",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-27",
"last_updated": "2008-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "OH",
"license": "36001409",
"primary": true
},
{
"code": "213ES0131X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot Surgery",
"state": "OH",
"license": "36001409",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0267214",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "000000130372",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Medina, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.