Organization Active NPI

Brookville Express Care & Wellness Center

  • Urgent Care Clinic/Center
  • Brookville, OH
National Provider Identifier
1144047440
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
BROOKVILLE EXPRESS CARE & WELLNESS CENTER
Practice address
430 Arlington Rd Ste B
Brookville, OH 45309-1103
Phone
(937) 641-9389
NPI assigned
Sep 26, 2024
Last updated
Apr 9, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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

Authorized official

Name
Mrs. Shelby Gonsales, APRN-CNP
Title
Nurse Practitioner
Phone
(937) 867-7700

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X NU Primary
Nurse Practitioner 363L00000X NU

Addresses

Primary practice location

430 Arlington Rd Ste B
Brookville, OH 45309-1103

Mailing address

430 Arlington Rd Ste B
Brookville, OH 45309-1103
Phone (937) 741-4888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250116003091 OH Part B Supplier - Clinic/Group Practice 9436687589 Receives reassigned benefits from 1 practitioner
Practice locations: Brookville, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2311798Brookville Express Care & Wellness Center430 Arlington Road Suite B, Brookville, OH 45309Certificate of waiverSep 29, 2026

National Provider Directory

National Provider Directory

Locations

430 Arlington Rd
#B
Brookville, OH 45309
Phone (937) 741-4888

430 Arlington Rd
Ste B
Brookville, OH 45309
Phone (937) 770-1265

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1727308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744156800000",
    "number": "1144047440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 ARLINGTON RD STE B",
            "city": "BROOKVILLE",
            "state": "OH",
            "postal_code": "453091103",
            "telephone_number": "937-741-4888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 ARLINGTON RD STE B",
            "city": "BROOKVILLE",
            "state": "OH",
            "postal_code": "453091103",
            "telephone_number": "937-641-9389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKVILLE EXPRESS CARE & WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-26",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A",
        "authorized_official_last_name": "GONSALES",
        "authorized_official_first_name": "SHELBY",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "937-867-7700",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APRN-CNP"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.