Individual provider Active NPI

Andrea Bessey Brubaker

  • Family Nurse Practitioner
  • Boone, NC
National Provider Identifier
1104342070
Registry record updated Sep 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5016213 Issued in NC
Practice address
141 Health Center Dr Ste B
Boone, NC 28607-6997
Phone
(828) 265-8591
NPI assigned
Aug 22, 2017
Last updated
Sep 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5016213 NC Primary

Addresses

Primary practice location

141 Health Center Dr Ste B
Boone, NC 28607-6997

Mailing address

141 Health Center Dr Ste B
Boone, NC 28607-6997
Phone (828) 265-8591

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171220002132 CA Practitioner - Nurse Practitioner 6608134671 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5016213NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Open Door Community Health Centers Current Accepting new patients
Ccclinic Inc CurrentSince Sep 24, 2023 Accepting new patients
Open Door Community Health Centers Current Accepting new patients
Open Door Community Health Centers Current Accepting new patients
Open Door Community Health Centers CurrentSince Oct 22, 2017 Accepting new patients
Open Door Community Health Centers Current Accepting new patients
Open Door Community Health Centers CurrentSince Oct 22, 2017 Accepting new patients

Locations

1275 8th St
Arcata, CA 95521

770 10th St
Arcata, CA 95521
Phone (707) 826-8610

785 18th St
Arcata, CA 95521
Phone (707) 822-2481

550 E Washington Blvd
Crescent City, CA 95531
Phone (707) 465-6925

2200 Tydd St
Eureka, CA 95501
Phone (707) 441-1624

1644 Central Ave
McKinleyville, CA 95519
Phone (707) 839-3068

670 9th St
Ste 203
McKinleyville, CA 95521

141 Health Center Dr
Ste B
Boone, NC 28607
Phone (828) 265-8591

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1503360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1104342070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 HEALTH CENTER DR STE B",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286076997",
            "telephone_number": "828-265-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 HEALTH CENTER DR STE B",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286076997",
            "telephone_number": "828-265-8591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUBAKER",
        "first_name": "ANDREA",
        "middle_name": "BESSEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-22",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5016213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boone, NC

Sources for this page

Verify at the official NPI Registry.