Individual provider Active NPI

Brooke E Organ, D.O.

  • Sports Medicine (Family Medicine) Physician
  • Washington, DC
National Provider Identifier
1295145167
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
036.157906 Issued in IL
Practice address
1760 Air Force Pentagon RM 4A870
Washington, DC 20330-1284
Phone
(703) 697-3255
NPI assigned
May 1, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS13475 FL
Family Medicine Physician 207Q00000X 036157906 IL
Sports Medicine (Family Medicine) Physician 207QS0010X 036.157906 IL Primary

Addresses

Primary practice location

1760 Air Force Pentagon RM 4A870
Washington, DC 20330-1284

Mailing address

1760 Air Force Pentagon RM 4A870
Washington, DC 20330-1760
Phone (703) 697-3255

Other practice location 1

3 Saint Elizabeth Blvd Ste 4000
O Fallon, IL 62269-1284
Phone (618) 233-5480

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20211230001558 IL Practitioner - Family Practice 4486089984 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.157906ILMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Illinois Healthcare Foundation, Inc. Family Medicine CurrentSince Oct 7, 2021 Accepting new patients
Southern Illinois Healthcare Foundation Inc CurrentSince Oct 7, 2021 Accepting new patients
Southern Illinois Healthcare Foundation Inc Family Medicine Current Accepting new patients

Locations

2001 State St
East St Louis, IL 62205
Phone (618) 271-0204

3 Saint Elizabeth Blvd
Ste 4000
O Fallon, IL 62269
Phone (618) 233-5480

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": "1398902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1295145167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 AIR FORCE PENTAGON RM 4A870",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "203301760",
            "telephone_number": "703-697-3255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 AIR FORCE PENTAGON RM 4A870",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "203301284",
            "telephone_number": "703-697-3255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Saint Elizabeth Blvd Ste 4000",
            "address_purpose": "LOCATION",
            "city": "O Fallon",
            "state": "IL",
            "postal_code": "622691284",
            "country_code": "US",
            "telephone_number": "618-233-5480",
            "fax_number": "618-222-4792",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ORGAN",
        "first_name": "BROOKE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-01",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS13475",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036157906",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "IL",
            "license": "036.157906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.