Individual provider Active NPI

Lisa Brooks, RN

  • Ambulatory Care Registered Nurse
  • Sitka, AK
National Provider Identifier
1174708473
Registry record updated Jan 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care Registered NurseTaxonomy code 163WP2201X
License
28001 Issued in AK
Practice address
222 Tongass Dr
Sitka, AK 99835-9416
Phone
(907) 966-8318
NPI assigned
Jan 4, 2008
Last updated
Jan 4, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Registered Nurse 163WP2201X 28001 AK Primary

Addresses

Primary practice location

222 Tongass Dr
Sitka, AK 99835-9416

Mailing address

1817 Sawmill Creek Rd
Sitka, AK 99835-9706
Phone (907) 747-1027

Other identifiers 1

IdentifierTypeStateIssuer
28001OtherAKALASKA STATE RN NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
28001AKMDAmbulatory Care Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1199404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199404800000",
    "number": "1174708473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1817 SAWMILL CREEK RD",
            "city": "SITKA",
            "state": "AK",
            "postal_code": "998359706",
            "telephone_number": "907-747-1027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 TONGASS DR",
            "city": "SITKA",
            "state": "AK",
            "postal_code": "998359416",
            "telephone_number": "907-966-8318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "LISA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-04",
        "last_updated": "2008-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "AK",
            "license": "28001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALASKA STATE RN NUMBER",
            "identifier": "28001",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sitka, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.