Melissa Lee Brookman, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

1010134474 Issued in VT

Practice address

128 Lakeside Ave Ste 115
Burlington, VT 05401-4936

Phone

(802) 860-1928

NPI assigned

Jan 4, 2024

Last updated

Jan 4, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

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.

• Lakeside Pediatrics, PLLC

  • Pediatrics Physician
  • Burlington, VT
  • NPI 1104880426
  NPD (past)

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

{
    "created_epoch": "1704326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1295505899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 LAKESIDE AVE STE 115",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054014936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 LAKESIDE AVE STE 115",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054014936",
            "telephone_number": "802-860-1928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKMAN",
        "first_name": "MELISSA",
        "middle_name": "LEE",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-04",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VT",
            "license": "1010134474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary Cole Breslin
• Andrew Bretti, MSW
• Jamie Brew
• Marcia M Bristow, MS RD CD
• Kevin John Brochu, P.A.
• Rebecca S. Brooks, LICSW, MSW
• Rayna Brosseau
• Daniel Brouwer, PHARMD
• Lillian Rose Brouwer, MD
• Aerial Brown

• Pediatric Nurse Practitioner in Burlington, VT
• Providers in Burlington, VT by specialty
• Pediatric Nurse Practitioner in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.