DR. GARRY J BROWN (NPI# 1043366925) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043366925 |
| Entity Type | Individual |
| Full Name | DR. GARRY J BROWN |
| Credential | DO |
| Practice Address |
1501 N Oakland Ave Bolivar MO 65613-3020 |
| Mailing Address |
Po Box 256 Salina KS 67402-0256 |
| Practice Telephone | 4173267200 |
| Practice Fax Number | 4173267201 |
| Mailing Telephone | 7858230633 |
| Mailing Fax Number | 7858230658 |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2020-02-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
2005041207 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | MEDICARE | 16701011 | 01 |
| MO | 20091105 | 05 | |
| AR | 161641103 | 05 | |
| KS | 200721240A | 05 | |
| MO | PTAN | 146240006 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265807515 | Garry Brown | Counselor | 2611 Wayne Ave Bldg 61, Dayton, OH 45420 | 2015-12-10 |
| 1063574812 | Garry G Brown | Optometrist | 719 Doctors Ct, Oshkosh, WI 54901-2077 | 2006-12-15 |
| 1326015520 | Garry M Brown | Radiology | 8020 Constitution Place Ne, #101, Albuquerque, NM 87110 | 2006-03-07 |
| Street Address |
1501 N OAKLAND AVE |
| City | BOLIVAR |
| State | MO |
| Zip Code | 65613-3020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396709895 | Leonid Shunyakov | Internal Medicine | 1501 N Oakland Ave, Bolivar, MO 65613-3020 | 2006-04-13 |
| 1750999231 | Bethany Martin | Nurse Practitioner | 1501 N Oakland Ave, Bolivar, MO 65613-3020 | 2020-07-21 |
| 1912560038 | Bailey Rundel | Nurse Practitioner | 1501 N Oakland Ave, Bolivar, MO 65613-3020 | 2019-04-15 |
| 1598244618 | Chloe Jo Michelle Wingert | Physician Assistant | 1501 N Oakland Ave, Bolivar, MO 65613-3020 | 2018-08-09 |
| 1982103784 | Jennifer Michelle White | Physician Assistant | 1501 N Oakland Ave, Bolivar, MO 65613 | 2018-02-07 |
| 1710427612 | Citizens Memorial Healthcare Foundation | Durable Medical Equipment & Medical Supplies | 1501 N Oakland Ave, Bolivar, MO 65613-3020 | 2017-02-27 |
| 1316372154 | Central Care Pa | Non-Pharmacy Dispensing Site | 1501 N Oakland Ave, Bolivar, MO 65613-3020 | 2013-09-12 |
| 1417202425 | Anjali M Edson | Physician Assistant | 1501 N Oakland Ave, Bolivar, MO 65613-3020 | 2012-07-16 |
| 1942575527 | Central Care, Pa | Specialist | 1501 N Oakland Ave, Bolivar, MO 65613-3020 | 2012-03-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891301552 | Casablanca Care Center, LLC | Home Health | 524 S. Albany Avenue, Bolivar, MO 65613 | 2020-09-18 |
| 1669087045 | Revive Medical LLC | Durable Medical Equipment & Medical Supplies | 5000, S Scenic, Bolivar, MO 65613 | 2020-09-11 |
| 1669097119 | Melanie Nicole Beckham | Nurse Practitioner | 1100 South Springfield Ave, Suite B, Bolivar, MO 65613 | 2020-06-10 |
| 1932754744 | Caitlin M Williams | Specialist/Technologist | 1260 S Pike Avenue, Bolivar, MO 65613 | 2019-08-08 |
| 1073022406 | Jacquelyn Rose Kemnic | Dietitian, Registered | Heart Center, 1500 N Oakland Ave, Willard, MO 65613 | 2017-09-28 |
| 1164897161 | Ozarks Resource Group | Clinic/Center | 203 E. Broadway St., Bolivar, MO 65613 | 2015-12-02 |
| 1962895292 | Professional Christian Counseling | Counselor | 4888 S 139th Road, Bolivar, MO 65613 | 2015-03-11 |
| 1073916573 | Scott Leslie Dennis | Physician Assistant | 1500 North Oakland Ave, Citizens Memorial Hospital, Bolivar, MO 65613 | 2014-09-29 |
| 1053712109 | Citizens Memorial Hospital District | Pharmacy | 1301-b North Oakland, Bolivar, MO 65613 | 2014-09-09 |
| 1740680453 | Jamee M Stimpson | Occupational Therapist | 454 S. Main Avenue, Bolivar, MO 65613 | 2014-08-29 |
| Find all providers in zip 65613 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639778228 | Central Care, Pa | Radiology | 1004 Carondelet Dr Ste 410, Kansas City, MO 64114-4801 | 2020-10-23 |
| 1245856046 | Jeevin Shahi | Radiology | 3685 Vista Avenue, Center for Radiation Medicine, St. Louis, MO 63110 | 2020-06-18 |
| 1518229772 | Andrew L Walker | Radiology | 902 N Riverside Rd Ste 201, Saint Joseph, MO 64507 | 2012-06-13 |
| 1568721454 | Jason Matthew Edwards | Radiology | 232 S Woods Mill Rd Ste 110e, Chesterfield, MO 63017 | 2012-05-11 |
| 1649569385 | Sagar Chandravadan Patel | Radiology | 211 Saint Francis Dr Ste 372, Cape Girardeau, MO 63703-5049 | 2011-04-04 |
| 1922326958 | Yvonne Thanh-nga D Pham | Radiology | 6601 Winchester Ave Ste 230, Kansas City, MO 64133-4681 | 2010-05-14 |
| 1811158587 | Benjamin Bin Yan | Radiology | 1111 Kentucky Ave., Omc Cancer Treatment Center, West Plains, MO 65775-2028 | 2008-06-24 |
| 1336338912 | Joseph Fields | Radiology | 9 Heather Hill Ln, Saint Louis, MO 63132-4105 | 2007-10-18 |
| 1205033941 | Associates In Tumor Therapy, Chartered | Radiology | 2801 Clearwater Ct, Joplin, MO 64801-8239 | 2007-06-27 |
| 1700916848 | Bethesda Resources Inc | Radiology | 1124 N Main St, Sikeston, MO 63801-5046 | 2007-03-07 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.