Active NPI
Hazel Lynnette Brooks, MD
- Pediatrics Physician
- Glasgow, KY
National Provider Identifier
1255314498
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 35803
- Practice address
- 301 Professional Park Dr
Glasgow, KY 42141-3487 - Phone
- (270) 651-9696
- Fax
- (270) 651-0385
- NPI assigned
- Nov 22, 2005
- Last updated
- May 15, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 35803 | KY | Primary |
Addresses
Primary practice location
301 Professional Park Dr
Glasgow, KY 42141-3487
Mailing address
PO Box 1080
Burkesville, KY 42717-1080
Phone (270) 864-1472
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64043474 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cumberland Family Medical Center Inc | Past | Accepting new patients | |
| T J Samson Community Hospital | Past | Accepting new patients |
Organizations & group practices 3
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.
-
dba Cumberland Family Medical Center
- Federally Qualified Health Center (FQHC)
- Burkesville, KY
- NPI 1306873500
-
dba Women's Care for the Commonwealth
- Federally Qualified Health Center (FQHC)
- Danville, KY
- NPI 1215918917
-
- General Acute Care Hospital
- Glasgow, KY
- NPI 1770581894
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400112000000",
"number": "1255314498",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1080",
"city": "BURKESVILLE",
"state": "KY",
"postal_code": "427171080",
"telephone_number": "270-864-1472",
"fax_number": "270-864-1693"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 PROFESSIONAL PARK DR",
"city": "GLASGOW",
"state": "KY",
"postal_code": "421413487",
"telephone_number": "270-651-9696",
"fax_number": "270-651-0385"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOKS",
"first_name": "HAZEL",
"middle_name": "LYNNETTE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-22",
"last_updated": "2014-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "KY",
"license": "35803",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64043474",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Glasgow, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2014; 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.