Individual provider Active NPI

Brooke Walter Pieper, A.P.R.N.

  • Primary Care Nurse Practitioner
  • Panguitch, UT
National Provider Identifier
1295570059
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
5138621-4405 Issued in UT
Practice address
948 S. 190 E.
Panguitch, UT 84759-1235
Phone
(435) 690-0237
NPI assigned
Jun 25, 2024
Last updated
Jun 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 5138621-4405 UT Primary

Addresses

Primary practice location

948 S. 190 E.
Panguitch, UT 84759-1235

Mailing address

308 E 4500 S Ste B
Murray, UT 84107-3957
Phone (801) 900-3280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20240814000774 UT Practitioner - Nurse Practitioner 7517405194

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5138621-4405UTMDPrimary Care Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: brooke.pieper.1@20544.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1719273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1295570059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 E 4500 S STE B",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841073957",
            "telephone_number": "801-900-3280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "948 S. 190 E.",
            "city": "PANGUITCH",
            "state": "UT",
            "postal_code": "847591235",
            "telephone_number": "435-690-0237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIEPER",
        "first_name": "BROOKE",
        "middle_name": "WALTER",
        "credential": "A.P.R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-25",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "UT",
            "license": "5138621-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panguitch, UT

Sources for this page

Verify at the official NPI Registry.