Brooke Ann Mactaggart, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

C176768 Issued in IA

Practice address

105 E Butler St
Manchester, IA 52057-1606

Phone

(563) 927-9400

Fax

(563) 927-6224

NPI assigned

Oct 17, 2023

Last updated

Mar 29, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in IA

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

Certified Pediatric Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rooted Pediatric Healthcare LLC

  • Primary Care Clinic/Center
  • Manchester, IA
  • NPI 1548029390

  Pediatrics

  NPD Authorized official
• Waves Healing Therapy, LLC

  • Clinical Social Worker
  • Manchester, IA
  • NPI 1053097113
  NPD (past)

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

{
    "created_epoch": "1697500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1194507954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 ANDERSON ST",
            "city": "MANCHESTER",
            "state": "IA",
            "postal_code": "520571401",
            "telephone_number": "319-480-2540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 E BUTLER ST",
            "city": "MANCHESTER",
            "state": "IA",
            "postal_code": "520571606",
            "telephone_number": "563-927-9400",
            "fax_number": "563-927-6224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACTAGGART",
        "first_name": "BROOKE",
        "middle_name": "ANN",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-17",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IA",
            "license": "C176768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Long Term Medical Supply Corporation
• Jena Lujan, D.C.
• Zachary Robert Lujan, D.C.
• Denise Lympus, ARNP
• Nicolette Mabb, DNP, ARNP, PMHNP-BC
• Manchester Dental DC
• Manchester Family Vision Center PC
• Nikolas S May, M.D.
• Sara Mae McCool, ARNP
• Thomas David McCoy, D.D.S.

• Pediatric Nurse Practitioner in Manchester, IA
• Providers in Manchester, IA by specialty
• Pediatric Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2024; 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.