Individual provider Active NPI

Fredrick Todd Brooking, M.D.

  • Family Medicine Physician
  • Spokane Valley, WA
National Provider Identifier
1265403745
Registry record updated May 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00044610 Issued in WA
Practice address
14402 E Sprague Ave Ste 16
Spokane Valley, WA 99216-2167
Phone
(509) 922-2645
Fax
(509) 922-4001
NPI assigned
Jan 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00044610 WA Primary

Addresses

Primary practice location

14402 E Sprague Ave Ste 16
Spokane Valley, WA 99216-2167

Mailing address

14402 E Sprague Ave
Spokane Valley, WA 99216-2167
Phone (509) 922-2625

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050607000033 WA Practitioner - Family Practice 6406899848 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

14402 E Sprague Ave
Spokane Valley, WA 99216-2167
Phone (509) 922-2625

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00044610WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington CurrentSince Jan 1, 2019 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Jan 1, 2019 Accepting new patients
Spokane Washington Hospital Company LLC Past Accepting new patients

Locations

19379 7th Ave NE
Poulsbo, WA 98370
Phone (360) 394-1000

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

14402 E Sprague Ave
Spokane Valley, WA 99216
Phone (509) 922-2525

14402 E Sprague Ave
Ste 16
Spokane Valley, WA 99216
Phone (509) 922-2645

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: tbrooking195784@ghc.direct-ci.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1265403745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14402 E SPRAGUE AVE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992162167",
            "telephone_number": "509-922-2625",
            "fax_number": "509-922-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14402 E SPRAGUE AVE STE 16",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992162167",
            "telephone_number": "509-922-2645",
            "fax_number": "509-922-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKING",
        "first_name": "FREDRICK",
        "middle_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-31",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00044610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "14402 E Sprague Ave Ste 16",
            "city": "Spokane Valley",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992162167",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

Verify at the official NPI Registry.