Active NPI
Justin Kenneth Brooten, MD
- Emergency Medicine Physician
- Winston Salem, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 2015-02465
- Practice address
- 1 Medical Center Blvd
Winston Salem, NC 27157-0001 - Phone
- (336) 716-2011
- NPI assigned
- Apr 28, 2014
- Last updated
- Mar 7, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | ||
| Emergency Medicine Physician | 207P00000X | 2015-02465 | NC | Primary |
Addresses
Primary practice location
1 Medical Center Blvd
Winston Salem, NC 27157-0001
Mailing address
PO Box 344
Winston Salem, NC 27102-0344
Phone (336) 716-2011
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Medical College of Georgia School of Medicine, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
250 Hospital Dr
Lexington, NC 27292-6792
Phone (336) 716-2734
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2015-02465 | NC | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wake Forest University Health Sciences | Current | Accepting new patients | |
| Wake Forest Emergency Providers | Current | Accepting new patients |
Locations
1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000
250 Hospital Dr
Lexington, NC 27292
Phone (336) 238-4150
557 Brookdale Dr
Statesville, NC 28677
Phone (330) 445-4361
Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697
Interoperability endpoints
- jbrooten2709621@carolinashealthcaresystem.direct-ci.com
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Multi-Specialty Clinic/Center
- Winston Salem, NC
- NPI 1003803032
-
- Multi-Specialty Clinic/Center
- Statesville, NC
- NPI 1396216735
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Lexington, NC
- NPI 1417958331
-
- Psychiatric Hospital Unit
- Winston Salem, NC
- NPI 1063480531
-
- Rehabilitation Hospital Unit
- Winston Salem, NC
- NPI 1114995677
-
dba Wake Forest Baptist Medical Center
- General Acute Care Hospital
- Winston Salem, NC
- NPI 1144211301
-
dba Wake Forest Baptist Medical Center
- Clinical Medical Laboratory
- Winston Salem, NC
- NPI 1609162098
Hospital
-
dba Winston East Pediatrics
- Pediatric Adolescent Medicine Physician
- Winston Salem, NC
- NPI 1912179219
Hospital
-
dba Wilkes Regional Medical Center
- General Acute Care Hospital
- North Wilkesboro, NC
- NPI 1881614071
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1520380800000",
"number": "1083024228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 344",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271020344",
"telephone_number": "336-716-2011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MEDICAL CENTER BLVD",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271570001",
"telephone_number": "336-716-2011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOTEN",
"first_name": "JUSTIN",
"middle_name": "KENNETH",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-04-28",
"last_updated": "2018-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NC",
"license": "2015-02465",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2018; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.