Individual provider Active NPI

Brooke E. Carpenter, APRN, FNP-C

  • Nurse Practitioner
  • Fort Thomas, KY
National Provider Identifier
1114266541
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3007817 Issued in KY
Practice address
85 N Grand Ave
Fort Thomas, KY 41075-1793
Phone
(859) 912-7211
Fax
(859) 655-6674
NPI assigned
Feb 5, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3007817 KY
Family Nurse Practitioner 363LF0000X 330723 OH
Nurse Practitioner 363L00000X 3007817 KY Primary

Addresses

Primary practice location

85 N Grand Ave
Fort Thomas, KY 41075-1793

Mailing address

PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 912-7211

Other practice location 1

1500 James Simpson Jr Way
Covington, KY 41011-0801
Phone (859) 912-7211

Other identifiers 3

IdentifierTypeStateIssuer
0080524MedicaidOH
P01516729OtherKYRR MEDICARE
7100239690MedicaidKY

Other names 1

  • Ms. Brooke E. Bonow Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20130227000566 KY Practitioner - Nurse Practitioner 5496900268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group IncGroup PAC ID 2163326240, 803 clinicians

Practice addresses (Care Compare)

1500 James Simpson Jr Way
Covington, KY 41011-0800
Phone (859) 655-4111

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
330723OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc Nurse Practitioner CurrentSince May 4, 2015 Accepting new patients
Summit Medical Group, Inc. CurrentSince May 4, 2015 Accepting new patients

Locations

125 Saint Michael Dr
Cold Spring, KY 41076
Phone (859) 441-3120

1500 James Simpson Jr Way
Covington, KY 41011
Phone (859) 655-4353

820 Dolwick Dr
Erlanger, KY 41018
Phone (859) 429-5188

85 N Grand Ave
Fort Thomas, KY 41075
Phone (859) 572-3100

1980 Litton Ln
Hebron, KY 41048
Phone (859) 334-8700

300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217

Interoperability endpoints

  • Direct secure messaging: bbonow178629@direct-prd.stelizabeth.com
  • Direct secure messaging: brooke.carpenter@1062722629074948.direct.elationemr.com

Organizations & group practices 2

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": "1360022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1114266541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "859-912-7211",
            "fax_number": "859-655-8981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 N GRAND AVE",
            "city": "FORT THOMAS",
            "state": "KY",
            "postal_code": "410751793",
            "telephone_number": "859-912-7211",
            "fax_number": "859-655-6674"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 James Simpson Jr Way",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "KY",
            "postal_code": "410110801",
            "country_code": "US",
            "telephone_number": "859-912-7211",
            "fax_number": "859-655-8981",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "BROOKE",
        "middle_name": "E.",
        "name_prefix": "Mrs.",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-05",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3007817",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "330723",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3007817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0080524",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01516729",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100239690",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BROOKE",
            "last_name": "BONOW",
            "middle_name": "E.",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Thomas, KY

Sources for this page

Verify at the official NPI Registry.