Andy Thomas Brooks, R.D.
Individual provider Active NPI Registered Dietitian · Hernando, MS
NPI 1083657902 · NPPES record last updated Jan 21, 2015
Key facts
- NPI
- 1083657902
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- D0908 (MS)
- Practice address
- 1989 Oak Tree CV Ste B
Hernando, MS 38632-1536 - Phone
- (901) 488-0681
- NPI assigned
- Jun 14, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0908 | MS | MD | Registered Dietitian |
| 002487 | GA | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Nutrition Specialists | Dietitian, Registered | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | D0908 | MS | Yes |
Addresses
Primary practice location
1989 Oak Tree CV Ste B
Hernando, MS 38632-1536
Mailing address
1989 Oak Tree CV Ste B
Hernando, MS 38632-1536
Phone (901) 488-0681
Other names
- Mr. Andy Thomas Brooks
Other providers in Hernando, MS
- Lauren Marie Blount
- William Boerger
- Ambreya Booker
- Stephen Robert Brasher
- Megan Bridges
- Georgina Brooks
- Charlette Brown
- Linda Brown
- Katie Brownlee
- Mrs.Monique Brunson
All providers in Hernando, MS · Registered Dietitian in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 21, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.