Roberta J Brooks, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2595 Issued in CO

Practice address

2127 E Harmony Rd
Suite 140
Fort Collins, CO 80528-3405

Phone

(970) 297-6250

Fax

(970) 297-6260

NPI assigned

Mar 24, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Heritage Family Medicine

  • Family Medicine Physician
  • Fort Collins, CO
  • NPI 1669535118
  NPD (past)
• Nicole Golding, M.D., P.S.C.

  • Physical Medicine & Rehabilitation Physician
  • Topeka, KS
  • NPI 1922144054

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364256000000",
    "number": "1003876087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3055 SANFORD CIR",
            "address_2": "SUITE 150",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805384925",
            "telephone_number": "970-624-4420",
            "fax_number": "970-624-4459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2127 E HARMONY RD",
            "address_2": "SUITE 140",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805283405",
            "telephone_number": "970-297-6250",
            "fax_number": "970-297-6260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "ROBERTA",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2013-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KS",
            "license": "1500312",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "2595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100377320D",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jordan Brooks, LCSW
• Joshua Evans Brooks, OD
• Lauren Marie Brooks, PA-C
• Lesley Clark Brooks, MD
• Molly Brooks, LAC, LPC
• Mark Alan Brosal, MA. LPC
• Seth Brost
• Neveon Brothe
• Larissa Nellie Brothers, DNP, APRN, FNP-BC
• Eric Martin Broughton, D.C.

• Physician Assistant in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2013; 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.