Active NPI
Jimmie Doyle Brown, DDS
- Dentist
- Temple, TX
National Provider Identifier
1962612085
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12799
- Practice address
- 4401 S General Bruce Dr
Temple, TX 76502-4802 - Phone
- (254) 791-5700
- Fax
- (254) 791-1772
- NPI assigned
- May 24, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 12799 | TX | Primary |
Addresses
Primary practice location
4401 S General Bruce Dr
Temple, TX 76502-4802
Mailing address
3014 Arrowhead Dr
Temple, TX 76502-1538
Phone (254) 791-5700
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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171005002016 | TX | Order and Referring Only - Dentist | 4880969575 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12799 | TX | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962612085",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3014 ARROWHEAD DR",
"city": "TEMPLE",
"state": "TX",
"postal_code": "765021538",
"telephone_number": "254-791-5700",
"fax_number": "254-791-1772"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4401 S GENERAL BRUCE DR",
"city": "TEMPLE",
"state": "TX",
"postal_code": "765024802",
"telephone_number": "254-791-5700",
"fax_number": "254-791-1772"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "JIMMIE",
"middle_name": "DOYLE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "12799",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Temple, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.