MAXWELL BROWN ENTERPRISE, LLC (NPI# 1487273223) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487273223 |
| Entity Type | Organization |
| Organization Name | MAXWELL BROWN ENTERPRISE, LLC |
| Practice Address |
250 E Apache St Tulsa OK 74106-3702 |
| Mailing Address |
10805 E 15th Pl Tulsa OK 74128-4808 |
| Practice Telephone | 9184085685 |
| Mailing Telephone | 9184085685 |
| Enumeration Date | 2020-04-12 |
| Last Update Date | 2020-04-12 |
| Authorized Official Name | DR. JOYCE ANN BROWN (PHYSICIAN/MEDICAL DIRECTOR) |
| Authorized Official Telephone | 9184085685 |
| Authorized Official Credential | DO, MPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| N | 101YP1600X |
Counselor Specialization: Pastoral |
Behavioral Health & Social Service Providers | ||
| N | 103TA0400X |
Psychologist Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 133NN1002X |
Nutritionist Specialization: Nutrition, Education |
Dietary & Nutritional Service Providers | ||
| N | 163W00000X | Registered Nurse | Nursing Service Providers | ||
| N | 164W00000X | Licensed Practical Nurse | Nursing Service Providers | ||
| N | 202C00000X | Independent Medical Examiner | Allopathic & Osteopathic Physicians | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 2083P0500X |
Preventive Medicine Specialization: Preventive Medicine/Occupational Environmental Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 2084P0802X |
Psychiatry & Neurology Specialization: Addiction Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 208VP0000X |
Pain Medicine Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 2083A0300X |
| Other Name | Type Code |
|---|---|
| LEGACY HEALTH | Doing Business As Name - Organization |
| Street Address |
250 E APACHE ST |
| City | TULSA |
| State | OK |
| Zip Code | 74106-3702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811538895 | Desma Johnson | Technician | 784 East 43rd Street North, Tulsa, OK 74106 | 2019-10-01 |
| 1912462094 | Breyan Lashawn Jackson | Case Manager/Care Coordinator | 3606 N Mlk Jr. Blvd, Tulsa, OK 74106 | 2019-02-04 |
| 1740751445 | Ernest Kaara Maina | Family Medicine | 3606 M.l.k. Jr Blvd, Tulsa, OK 74106 | 2018-12-07 |
| 1568969632 | A&m Healthcare Clinic | Nurse Practitioner | 3606 North Mlk Blvd, Tulsa, OK 74106 | 2018-04-06 |
| 1265880819 | Paula Patricia Tullis | Psychologist | 1232 N Boston, Tulsa, OK 74106 | 2016-05-24 |
| 1326413030 | Eartha Mcalester | Counselor | 628 E. Virgin St., Tulsa, OK 74106 | 2015-12-07 |
| 1114334182 | James O Brannon Jr. | Behavioral Analyst | 2745 North Main, Tulsa, OK 74106 | 2014-07-22 |
| 1952718512 | Teresa Marie Williams | Counselor | 3601 N. Martin Luther King Blvd, Tulsa, OK 74106 | 2014-07-16 |
| 1639580764 | Lynnette Dixon | Case Management | 708 East 38th Street North, Tulsa, OK 74106 | 2014-05-12 |
| 1184975898 | Tiara Delonia | Social Worker | 1 W 36th St N Suite 1, Tulsa, OK 74106 | 2012-09-21 |
| Find all providers in zip 74106 | ||||
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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.