Active NPI
Rosemary Ann Brixie, FAMILY NURSE PRACTIT
- Nurse Practitioner
- Lodi, CA
National Provider Identifier
1114253101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 18954
- Practice address
- 2401 W Turner Rd
Suite 450
Lodi, CA 95242-2182 - Phone
- (209) 370-1700
- NPI assigned
- Oct 26, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 18954 | CA | Primary |
Addresses
Primary practice location
2401 W Turner Rd
Suite 450
Lodi, CA 95242-2182
Mailing address
17450 E Highway 4
Stockton, CA 95215-9456
Phone (209) 482-1017
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190515001428 | CA | Order and Referring Only - Nurse Practitioner | 4183802382 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18954 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1256515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359676800000",
"number": "1114253101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17450 E HIGHWAY 4",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952159456",
"telephone_number": "209-482-1017"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2401 W TURNER RD",
"address_2": "SUITE 450",
"city": "LODI",
"state": "CA",
"postal_code": "952422182",
"telephone_number": "209-370-1700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRIXIE",
"first_name": "ROSEMARY",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "FAMILY NURSE PRACTIT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-10-26",
"last_updated": "2013-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "18954",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lodi, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2013; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.