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JACKQULYN BROWN
NPI 1194591719
Nurse Practitioner - Family in Southfield, MI

Active since November 27, 2023PECOS Enrolled
20755 GREENFIELD RD STE 100, SOUTHFIELD, MI 48075(248) 557-0507 Get Directions Write a Review

NPPES record last updated: November 27, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Jackqulyn Brown NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACKQULYN BROWN (NPI 1194591719) is an individual family provider in Southfield, Michigan, licensed in Michigan (4704342245) and active in the NPI registry since November 2023. She is enrolled in Medicare PECOS, is affiliated with Beaumont Hospital Royal Oak, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1194591719
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameJACKQULYN BROWN
Location Address20755 GREENFIELD RD STE 100Southfield, MI 48075-5400
Mailing Address20755 Greenfield Rd Ste 100Southfield, MI 48075-5400 · (313) 529-6050
Phone(248) 557-0507
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateNovember 27, 2023
NPPES CertifiedNovember 27, 2023
✔ NPI 1194591719 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in MI · 4704342245
Also ListedRegistered NurseTaxonomy 163W00000X · License 4704342245 (MI)
20755 GREENFIELD RD STE 100, Southfield, MI 48075
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jackqulyn Brown is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8426537358
PECOS Enrollment IDI20260210002770
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Beaumont Hospital Royal Oak

Acute Care Hospitals · Royal Oak, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230130
Location3601 W Thirteen Mile RdRoyal Oak, MI 48073 · Oakland County
Emergency services Birthing friendly

Beaumont Hospital - Farmington Hills

Acute Care Hospitals · Farmington Hills, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230151
Location28050 Grand River AvenueFarmington Hills, MI 48336 · Oakland County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48075 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$90.76 typical visit price
range $58.04 – $177.36
Typical copayment $22.69 (range $14.51 – $44.34)
Most-billed visit code 99203
Established Patient
$102.35 typical visit price
range $18.32 – $143.49
Typical copayment $25.58 (range $4.58 – $35.87)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ULTIMATE MEDICAL CARE PLC
Family Medicine
20755 GREENFIELD RD STE 100
SOUTHFIELD, MI 48075
Oakland County (947) 282-5009
DERRICK WILLIAMSON DO
Family Medicine
20755 GREENFIELD RD STE 100
SOUTHFIELD, MI 48075
Oakland County (947) 282-5009
REMI O SOILE M.D.
Internal Medicine
20755 GREENFIELD RD STE 100, SUITE 100
SOUTHFIELD, MI 48075
Oakland County (248) 557-0507
DR. HANI M SAAD M.D.
Internal Medicine
20755 GREENFIELD RD STE 100
SOUTHFIELD, MI 48075
Oakland County (313) 407-1545
SHARON OBUZOR FNP
Nurse Practitioner (Family)
20755 GREENFIELD RD STE 100
SOUTHFIELD, MI 48075
Oakland County (248) 557-0507
SAAD PROFESSIONAL SERVICES LLC
Internal Medicine
20755 GREENFIELD RD STE 100
SOUTHFIELD, MI 48075
Oakland County (313) 407-1545

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jackqulyn Brown's NPI number?

The NPI number for Jackqulyn Brown is 1194591719. It was assigned to this individual provider in the NPPES registry on November 27, 2023.

Where is Jackqulyn Brown located?

Jackqulyn Brown practices at 20755 Greenfield Rd Ste 100, Southfield, MI 48075. The listed phone number is (248) 557-0507.

What is Jackqulyn Brown's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Jackqulyn Brown enrolled in Medicare?

Yes. Jackqulyn Brown is registered in the Medicare PECOS enrollment system.

Is Jackqulyn Brown affiliated with any hospitals?

According to CMS data, Jackqulyn Brown is affiliated with Beaumont Hospital Royal Oak and Beaumont Hospital - Farmington Hills.

When was this NPI record last updated?

The NPPES record for Jackqulyn Brown was last updated on November 27, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.