Individual provider Active NPI

Jessica Louise Brooks, FNP

  • Family Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1225775414
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5016752 Issued in NC
Practice address
8824 E Bellhaven Blvd
Charlotte, NC 28214-6775
Phone
(704) 595-3742
Fax
(704) 595-3788
NPI assigned
May 18, 2022
Last updated
Mar 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 5016752 NC Primary

Addresses

Primary practice location

8824 E Bellhaven Blvd
Charlotte, NC 28214-6775

Mailing address

2319 Pimpernel Rd
Charlotte, NC 28213-6775
Phone (704) 595-3742

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20221108003682 NC Practitioner - Nurse Practitioner 7810363132 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ars Home Care LLC CurrentSince Mar 3, 2024 Accepting new patients
Signify Health Medical Associates, PLLC Single Specialty CurrentSince Jan 1, 2023 Accepting new patients
Ars Medical , PLLC. Single Specialty CurrentSince Feb 8, 2023 Accepting new patients
Theoria Medical Family Medicine Past Accepting new patients

Locations

5736 N Tryon St
Ste 105
Charlotte, NC 28213
Phone (704) 494-8456

8824 Bellhaven Blvd
Charlotte, NC 28214
Phone (704) 595-3742

8824 Bellhaven Blvd
Ste E
Charlotte, NC 28214

1480 Concord Pkwy N
Ste 350
Concord, NC 28025
Phone (704) 343-5005

555 Fayetteville St
Raleigh, NC 27601
Phone (682) 268-1011

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1652832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1225775414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2319 PIMPERNEL RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282136775",
            "telephone_number": "704-595-3742",
            "fax_number": "704-595-3788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8824 E BELLHAVEN BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282146775",
            "telephone_number": "704-595-3742",
            "fax_number": "704-595-3788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "JESSICA",
        "middle_name": "LOUISE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-18",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5016752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.