Rebecca Angeles Denise Brown, NP-C
Individual provider Active NPI Acute Care Nurse Practitioner · Tifton, GA
NPI 1972997799 · NPPES record last updated Aug 10, 2015
Key facts
- NPI
- 1972997799
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Acute Care Nurse Practitioner 363LA2100X
- License
- RN170184 (GA)
- Practice address
- 2225 US Highway 41 N
Tifton, GA 31794-2749 - Phone
- (229) 391-4100
- NPI assigned
- Mar 19, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- South Georgia Medical Center Inc
Practice addresses (Care Compare)
2501 N Patterson St
Valdosta, GA 31602-1735
Phone (229) 433-1000
Hospital & facility affiliations
- SGMC Health
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151014002361 | GA | Practitioner - Nurse Practitioner | 2062721020 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN170184 | GA | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Georgia Medical Center Inc | Current |
Accepting new patients | |
| South Georgia Medical Center Inc | Current |
Accepting new patients |
Locations
2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139
2330 N Ashley St
Valdosta, GA 31602
Phone (229) 249-5080
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | RN170184 | GA | Yes |
Addresses
Primary practice location
2225 US Highway 41 N
Tifton, GA 31794-2749
Mailing address
4075 Grande Oaks Dr
Valdosta, GA 31605-7732
Phone (229) 269-9320
Other providers in Tifton, GA
- Lee Michelle Brooks
- Dale Broome
- Clinton Jeffery Brown
- Donovan Kaine Brown
- Karen Elizabeth Brown
- Stacy Brown
- Marsha S. Browning
- Stanley Todd Bruce Jr.
- Charles E Bryan Jr.
- Joseph Vance Bryant
All providers in Tifton, GA · Acute Care Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 10, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.