Jack Alan Brown III

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

17531 Issued in OR

Practice address

200 Redwood Hwy
Grants Pass, OR 97527-5404

Phone

(541) 659-1703

NPI assigned

Oct 17, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Elemental Healing Arts Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476662400000",
    "number": "1982155768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 REDWOOD HWY",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275404",
            "telephone_number": "541-659-1703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 REDWOOD HWY",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275404",
            "telephone_number": "541-659-1703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JACK",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-17",
        "last_updated": "2016-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "17531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELEMENTAL",
            "last_name": "ARTS",
            "middle_name": "HEALING",
            "credential": "LMT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Annabell Marie Brown
• Cara Brown, QMHA
• Caroline Jean Brown, M.D.
• Cheryl Lee Brown, LPC
• Duward Jakob Brown
• Jason Matthew Brown, B.A.
• Monica Brown
• Teresa Brown
• Bruce E Perry MD
• Jennifer Lynn Bruce

• Massage Therapist in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Massage Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; 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.