Individual provider Active NPI

Tedra Anderson-Brown, MD

  • Psychiatry Physician
  • Morrisville, NC
National Provider Identifier
1992069470
Registry record updated Jun 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
95-00495 Issued in NC
Practice address
3800 Paramount Pkwy
Suite 150
Morrisville, NC 27560-6949
Phone
(919) 674-2463
Fax
(919) 379-5576
NPI assigned
Jun 28, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 95-00495 NC Primary

Addresses

Primary practice location

3800 Paramount Pkwy
Suite 150
Morrisville, NC 27560-6949

Mailing address

3800 Paramount Pkwy
Suite 150
Morrisville, NC 27560-6949
Phone (919) 674-2463

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
95-00495NCMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1340841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340841600000",
    "number": "1992069470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 PARAMOUNT PKWY",
            "address_2": "SUITE 150",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275606949",
            "telephone_number": "919-674-2463",
            "fax_number": "919-379-5576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 PARAMOUNT PKWY",
            "address_2": "SUITE 150",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275606949",
            "telephone_number": "919-674-2463",
            "fax_number": "919-379-5576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON-BROWN",
        "first_name": "TEDRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-28",
        "last_updated": "2012-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "95-00495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morrisville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2012; 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.