Jennifer Lynne Brooks, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

085003316 Issued in IL

Practice address

1801 N 6TH St Ste 600
Terre Haute, IN 47804-4097

Phone

(812) 235-4867

Fax

(812) 232-8059

NPI assigned

Sep 24, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Jennifer Lynne Atkins Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1222214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400457600000",
    "number": "1023268240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 N 6TH ST STE 600",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478044097",
            "telephone_number": "812-235-4867",
            "fax_number": "812-232-8059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 N 6TH ST STE 600",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478044097",
            "telephone_number": "812-235-4867",
            "fax_number": "812-232-8059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "JENNIFER",
        "middle_name": "LYNNE",
        "name_prefix": "Miss",
        "credential": "PAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-24",
        "last_updated": "2014-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085003316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "940939",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "153063",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "ATKINS",
            "middle_name": "LYNNE",
            "credential": "PAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Haley Britton, PHARMD
• Savanna Ann Britton
• Ian McCoy Brittton, BCABA
• Gregory K Brock, DO
• Kelly Brock, LAT, ATC
• Whitney Brooks, FNP-C
• Binne Brouwer, ATC, CSCS, CAT(C)
• Brown Orthopedics, LLC
• Amy Jenee Brown
• Apryl Brown, PMHNP-BC, RN-BC

• Medical Physician Assistant in Terre Haute, IN
• Providers in Terre Haute, IN by specialty
• Medical Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.