Individual provider Active NPI

Brookanne J Mickelson, FNP-BC

  • Family Nurse Practitioner
  • St George, UT
National Provider Identifier
1013916915
Registry record updated Apr 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
222657-4405 Issued in UT
Practice address
2891 E Mall Dr Ste 101
St George, UT 84790-2399
Phone
(435) 656-2424
Fax
(435) 656-2828
NPI assigned
Jul 21, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 222657-4405 UT Primary

Addresses

Primary practice location

2891 E Mall Dr Ste 101
St George, UT 84790-2399

Mailing address

PO Box 912042
St George, UT 84791-2042
Phone (435) 656-2424

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070503000460 UT Practitioner - Nurse Practitioner 6800992041 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Spine and Pain Care Specialists LLCGroup PAC ID 6406020049, 42 clinicians

Practice addresses (Care Compare)

25 N 2000
Suite 8
Hurricane, UT 84737-4115
Phone (435) 635-0174

2891 E Mall Dr
Suite 102
St George, UT 84790-2399
Phone (435) 703-2930

Hospital & facility affiliations

  • St. George Regional Hospital Hospital, St George, UT, CCN 460021

Merit-based Incentive Payment System (MIPS)

Final score
78.97 of 100Reported as group
Quality
68.31
Promoting interoperability
86
Improvement activities
40
Cost
73.25

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dixie Palliative Care, LLC CurrentSince Aug 3, 2022 Accepting new patients
Southwest Spine and Pain Care Specialists, LLC CurrentSince Nov 20, 2014 Accepting new patients
Southwest Spine and Pain Care Specialists, LLC CurrentSince Nov 20, 2014 Accepting new patients
Axxis Wellness LLC PastSince Jun 12, 2022 Accepting new patients

Locations

1303 N Main St
Cedar City, UT 84721
Phone (435) 586-2229

25 N 2000 W
Ste 8
Hurricane, UT 84737
Phone (435) 635-0174

652 S Medical Center Dr
Ste 110
St George, UT 84790
Phone (435) 215-0230

2891 E Mall Dr
Ste 101
St George, UT 84790
Phone (435) 879-7610

352 E Riverside Dr
Ste B3B
St George, UT 84790
Phone (435) 628-8347

2051 E Red Hills Pkwy
Ste 7
St George, UT 84770
Phone (435) 703-2930

301 N 200 E
Ste 2A
St George, UT 84770
Phone (435) 628-3651

652 S Medical Center Dr
Ste 400
St George, UT 84790
Phone (435) 251-2650

Networks

  • UT PPO
  • UT PPO D-SNP

Interoperability endpoints

  • Direct secure messaging: brookanne.mickelson@ssapcsl-ut.direct.office.nextgen.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775088000000",
    "number": "1013916915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 912042",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847912042",
            "telephone_number": "435-656-2424",
            "fax_number": "435-656-2828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2891 E MALL DR STE 101",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847902399",
            "telephone_number": "435-656-2424",
            "fax_number": "435-656-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKELSON",
        "first_name": "BROOKANNE",
        "middle_name": "J",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-21",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "222657-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

Verify at the official NPI Registry.