Carol Lynn Brokschmidt, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

19747 Issued in AZ

Practice address

Corner of RT. N12 and N7
Fort Defiance PHS Hospital
Fort Defiance, AZ 86504

Phone

(928) 729-8757

NPI assigned

Oct 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Northbay Healthcare Group

  • General Acute Care Hospital
  • Fairfield, CA
  • NPI 1821147786
  Medicare reassignment NPD
• Northbay Healthcare Group

  • Multi-Specialty Clinic/Center
  • Vacaville, CA
  • NPI 1760534713
  NPD
• DHHS PHS Naihs Fort Defiance Hospital

  • General Acute Care Hospital
  • Fort Defiance, AZ
  • NPI 1700962131
  NPD (past)
• Dignity Health Medical Foundation

  • Multi-Specialty Clinic/Center
  • Redding, CA
  • NPI 1912288432
  NPD (past)
• OB GYN Associates of the Central Coast

  • Obstetrics & Gynecology Physician
  • Salinas, CA
  • NPI 1215980925
  NPD (past)
• Phelps & Associates Physical Therapy

  • Specialist
  • Salinas, CA
  • NPI 1245311950
  NPD (past)

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124104112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9522 E MINTON ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852072538",
            "telephone_number": "480-354-8766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CORNER OF RT. N12 AND N7",
            "address_2": "FORT DEFIANCE PHS HOSPITAL",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "86504",
            "telephone_number": "928-729-8757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROKSCHMIDT",
        "first_name": "CAROL",
        "middle_name": "LYNN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "19747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "19747",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS",
            "identifier": "893356",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "52424553",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ulysses S Bowler Jr., MD
• Rebecca Bowling, RN
• Hunter M Bowring
• Valentina V Brandon, RN
• Dana Claire Brewer, CNM
• Lillian Bronson, APRN
• Linda Brown Trudel, MD
• Cleveland Brown IV
• Jason Andrew Brown, MD
• Kimberly Rene Brown

• Obstetrics & Gynecology Physician in Fort Defiance, AZ
• Providers in Fort Defiance, AZ by specialty
• Obstetrics & Gynecology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.