Jonathan Keith Brooks, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2815 Issued in CO

Practice address

29029 Upper Bear Creek Rd Ste 305
Evergreen, CO 80439-7722

Phone

(303) 838-7595

NPI assigned

Dec 6, 2007

Last updated

Dec 6, 2007By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 1, 2015 through Oct 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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.

• Jonathan K. Brooks PHD PC

  • Clinical Psychologist
  • Evergreen, CO
  • NPI 1366612921
  Authorized official Same address or phone

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

{
    "created_epoch": "1196899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196899200000",
    "number": "1104009620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1532",
            "city": "CONIFER",
            "state": "CO",
            "postal_code": "804331532",
            "telephone_number": "303-838-7595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29029 UPPER BEAR CREEK RD STE 305",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "804397722",
            "telephone_number": "303-838-7595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "JONATHAN",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-06",
        "last_updated": "2007-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "2815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Brand, MPT
• Michelle Breault
• Anne L. Brockman, M.D.
• Ann Marie Brodsky, PT, DPT
• Brooke Harris Counseling PLLC (Creative Counseling of Evergreen)
• Brandon Brown
• Kloee Brown
• Laura Brown, LCSW
• Seth Brown
• Suzanne Brown, RD

• Clinical Psychologist in Evergreen, CO
• Providers in Evergreen, CO by specialty
• Clinical Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.