Individual provider Active NPI

Cathy Brook, COMMUNITY HEALTH

  • Community Health Worker
  • Bemidji, MN
National Provider Identifier
1104601079
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
206 Minnesota Ave NW
Bemidji, MN 56601-4027
Phone
(218) 444-9038
NPI assigned
Aug 29, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X MN Primary

Addresses

Primary practice location

206 Minnesota Ave NW
Bemidji, MN 56601-4027

Mailing address

PO Box 1764
Bemidji, MN 56619-1764
Phone (218) 444-9038

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Housing Matters, LLC CurrentSince Sep 5, 2023 Accepting new patients

Locations

206 Minnesota Ave NW
Bemidji, MN 56601
Phone (218) 444-9038

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1693267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1104601079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1764",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566191764",
            "telephone_number": "218-444-9038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 MINNESOTA AVE NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566014027",
            "telephone_number": "218-444-9038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOK",
        "first_name": "CATHY",
        "credential": "COMMUNITY HEALTH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-29",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bemidji, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.