Phillip Maurice Brockington, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

168873 Issued in MO

Practice address

6724 Troost Ave
Suite 407
Kansas City, MO 64131-1501

Phone

(816) 333-2455

NPI assigned

Dec 19, 2006

Sex

Male

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 1

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: phillip.brockington.p7@direct.360care.nextgenshare.com
• Direct secure messaging: phillip.brockington.p6@direct.360care.nextgenshare.com

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.

• Special Care Dental of Missouri LLC

  • Dentist
  • Leawood, KS
  • NPI 1790127512

  MO

  Medicare reassignment NPD

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212624000000",
    "number": "1063575967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6724 TROOST AVE",
            "address_2": "SUITE 407",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641311501",
            "telephone_number": "816-333-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6724 TROOST AVE",
            "address_2": "SUITE 407",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641311501",
            "telephone_number": "816-333-2455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKINGTON",
        "first_name": "PHILLIP",
        "middle_name": "MAURICE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2008-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "168873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400586103",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Briva Home Health Inc
• Briva Home Healthcare LLC
• Denise Ann Broadus
• Mickey Brock
• Sheri Brockett, RN IBCLC
• Kriste Brockway
• Mark J Brodkey, MD
• Aaron Broeckelman, LMSW
• David Bromberg
• Sarah Jane Bromley, MD

• General Practice Dentistry in Kansas City, MO
• Providers in Kansas City, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2008; 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.