Individual provider Active NPI

Jennifer Lynn Brosius, ARNP

  • Family Nurse Practitioner
  • Martinsburg, WV
National Provider Identifier
1285379388
Registry record updated Mar 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
113373 Issued in WV
Practice address
510 Butler Ave
Martinsburg, WV 25405-9990
Phone
(304) 263-0811
NPI assigned
May 3, 2022
Last updated
Mar 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 113373 WV Primary

Addresses

Primary practice location

510 Butler Ave
Martinsburg, WV 25405-9990

Mailing address

510 Butler Ave
Martinsburg, WV 25405-9990
Phone (304) 263-0811

Other practice location 1

84 Somerset Blvd
Charles Town, WV 25414-4827
Phone (304) 728-8533

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20231228002534 WV Order and Referring Only - Nurse Practitioner 2769832039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1651536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1285379388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 BUTLER AVE",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254059990",
            "telephone_number": "304-263-0811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 BUTLER AVE",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254059990",
            "telephone_number": "304-263-0811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "84 Somerset Blvd",
            "address_purpose": "LOCATION",
            "city": "Charles Town",
            "state": "WV",
            "postal_code": "254144827",
            "country_code": "US",
            "telephone_number": "304-728-8533",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROSIUS",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-03",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "113373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsburg, WV

Sources for this page

Verify at the official NPI Registry.