Brooke D Gipson, NP-C
Individual provider Active NPI Family Nurse Practitioner · Moberly, MO
NPI 1104291350 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1104291350
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 2015042865 (MO)
- Practice address
- 1319 E Highway 24
Moberly, MO 65270-3682 - Phone
- (660) 263-6643
- Fax
- (660) 263-0333
- NPI assigned
- Dec 13, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
-
Thomas A Bragg, D.O.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170602000707 | MO | Practitioner - Nurse Practitioner | 6709153380 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2015042865 | MO | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Preferred Family Healthcare, Inc. | Current |
Accepting new patients | |
| Preferred Family Healthcare, Inc | Current | Accepting new patients | |
| Preferred Family Healthcare, Inc. | Current |
Accepting new patients | |
| Preferred Family Healthcare, Inc. | Past | Accepting new patients | |
| Preferred Family Healthcare Inc | Past | Accepting new patients |
Locations
1 Healthcare Pl
Bowling Green, MO 63334
Phone (573) 324-2111
301 W Martin St
Cairo, MO 65239
Phone (660) 263-2788
4600 McMasters Ave
Hannibal, MO 63401
141 Communication Dr
Hannibal, MO 63401
Phone (573) 795-7342
3531 Stardust Dr
Hannibal, MO 63401
Phone (573) 248-3900
900 E Laharpe St
Kirksville, MO 63501
1625 Gratz Brown St
Moberly, MO 65270
420 N Washington St
Monroe City, MO 63456
Phone (573) 735-4631
4066 Dunnica Ave
Saint Louis, MO 63116
Phone (314) 361-1630
2114 SE Washington Blvd
Bartlesville, OK 74006
Phone (918) 876-4211
116 W 7th Ave
Ste 222
Stillwater, OK 74074
Phone (405) 743-2945
Interoperability endpoints
- brooke.gipson.p1@direct.pfh.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 2015042865 | MO | Yes |
Addresses
Primary practice location
1319 E Highway 24
Moberly, MO 65270-3682
Mailing address
1319 E Highway 24
Moberly, MO 65270-3682
Phone (660) 263-6643
Other providers in Moberly, MO
- Joseph William Galaske
- Heather Marie Gessling
- Rebecca Gibson
- Daniel R Gilbert
- Christine Marie Ginter
- Sharon V Goen
- Frederic Lee Gottman
- Brandi Nicole Grant
- Terry Wayne Griggs
- Kevin Dean Gunnerson
All providers in Moberly, MO · Family Nurse Practitioner in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.