Julie Anne Brockman, APRN-CNP

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

License

4704438112 Issued in MI

Practice address

3584 Fairlanes Ave SW Ste 2
Grandville, MI 49418-1583

Phone

(616) 797-2124

NPI assigned

Jun 10, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Madison Health Hospital, London, OH, CCN 360189

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jbrockman1239455@direct.osumc.edu

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.

• Mount Carmel - Osu Physician Alliance LLC

  • Family Medicine Physician
  • London, OH
  • NPI 1871913731
  Medicare reassignment NPD
• Allergy and Asthma Center, Inc

  • Allergy & Immunology Physician
  • Wilmington, OH
  • NPI 1104913417
  NPD (past)
• Madison County Hospital Hospice

  • Community Based Hospice Care Agency
  • London, OH
  • NPI 1164698338
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Madison County Community Hospital

  • General Acute Care Hospital
  • London, OH
  • NPI 1982710703
  Care Compare affiliation

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

{
    "created_epoch": "1717977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1104668102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "740-956-1360",
            "fax_number": "740-869-1160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3584 FAIRLANES AVE SW STE 2",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494181583",
            "telephone_number": "616-797-2124"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "164 E Main St",
            "address_purpose": "LOCATION",
            "city": "Mount Sterling",
            "state": "OH",
            "postal_code": "431431145",
            "country_code": "US",
            "telephone_number": "740-956-1360",
            "fax_number": "740-869-1160",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1585 Neil Ave",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432101216",
            "country_code": "US",
            "telephone_number": "614-292-4041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROCKMAN",
        "first_name": "JULIE",
        "middle_name": "ANNE",
        "credential": "APRN-CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-10",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "MI",
            "license": "4704438112",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0036640",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Ruth Branon, LPN
• Sara Marie Bredt
• Brian Cilla DDS Ms PC
• Mikayla M Briggs
• Lisbet Brito, LPC
• Rhonda S Broek, LMSW
• Timothy Edward Broekhuizen, PHARM.D
• Audrey Brokenshire
• Samantha Lynn Brooks
• Melissa Ann Brophy, MA. LPC CAADC

• Addiction Medicine (Family Medicine) Physician in Grandville, MI
• Providers in Grandville, MI by specialty
• Addiction Medicine (Family Medicine) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.