NPIMap

Organization Active NPI

Brooke a. Bisbee, DPM, PA

  • Primary Podiatric Medicine Podiatrist
  • Rogers, AR
National Provider Identifier
1114147691
Registry record updated Oct 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
Legal business name
BROOKE A. BISBEE, DPM, PA
Practice address
200 S 20TH St
Ste. B
Rogers, AR 72758-1104
Phone
(479) 636-9393
NPI assigned
Apr 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2023

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

Authorized official

Name
Brooke A Bisbee, DPMNPI 1427044353
Title
Owner
Phone
(479) 636-9393

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213EP1101X Primary
Prosthetic/Orthotic Supplier 335E00000X

Addresses

Primary practice location

200 S 20TH St
Ste. B
Rogers, AR 72758-1104

Mailing address

200 S 20TH Street
Ste. B
Rogers, AR 72758-1104
Phone (479) 636-9393

Other identifiers 1

IdentifierTypeStateIssuer
146125748MedicaidAR

Other names 1

  • Family Foot Health Center, PA Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100924001051 AR Part B Supplier - Clinic/Group Practice 2961528179 Receives reassigned benefits from 5 practitioners
Practice locations: Berryville, AR; Rogers, AR
O20100930056310 AR DME Supplier - Physician - Podiatry 2961528179 Practice locations: Rogers, AR

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Brooke a Bisbee DPM PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

200 S 20th St
Ste B
Rogers, AR 72758
Phone (479) 636-9393

4600 Mercy Ln
Ste 110
Springdale, AR 72762
Phone (479) 338-4400

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698364800000",
    "number": "1114147691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S 20TH STREET",
            "address_2": "STE. B",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727581104",
            "telephone_number": "479-636-9393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S 20TH ST",
            "address_2": "STE. B",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727581104",
            "telephone_number": "479-636-9393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKE A. BISBEE, DPM, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A",
        "authorized_official_last_name": "BISBEE",
        "authorized_official_first_name": "BROOKE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-636-9393",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146125748",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Foot Health Center, PA",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Family Foot Health Center, PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rogers, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.