Steffany R Brockman, RN

Primary specialty

Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X

License

2014036817 Issued in MO

Practice address

11661 College Blvd
Overland Park, KS 66210-4107

Phone

(913) 432-8400

Fax

(913) 432-8402

NPI assigned

Jun 17, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other names 1

• Steffany R Wooderson Professional name

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

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.

• Prompt Medical Clinic Inc.

  • Internal Medicine Physician
  • Independence, MO
  • NPI 1942252945
  Medicare reassignment NPD
• Prompt Medical Clinic Inc

  • Acute Care Nurse Practitioner
  • Independence, MO
  • NPI 1982863718
  NPD (past)

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

{
    "created_epoch": "1371427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436832000000",
    "number": "1114366754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1253 E WALNUT ST",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640504162",
            "telephone_number": "816-260-6667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11661 COLLEGE BLVD",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662104107",
            "telephone_number": "913-432-8400",
            "fax_number": "913-432-8402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKMAN",
        "first_name": "STEFFANY",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-17",
        "last_updated": "2015-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2002017255",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KS",
            "license": "14107455061",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "KS",
            "license": "53-76600-061",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2014036817",
            "primary": false
        },
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "MO",
            "license": "2014036817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEFFANY",
            "last_name": "WOODERSON",
            "middle_name": "R",
            "credential": "APRN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Bristol Hospice Kansas LLC
• Kenzie N Britton
• Jaimee Marissa Broadus
• Elizabeth Brock, BCABA
• Larry Brockhaus
• Katerina Brockmann
• Eric Brocksmith, DPT
• Nicole Brodie, DC
• Barry Michael Broeckelman, M.D.
• Kristin Brokaw, OTR

• Adult Health Clinical Nurse Specialist in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Adult Health Clinical Nurse Specialist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2015; 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.

Verify at the official NPI Registry.