Brooke Carlyle, APRN, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2018019839 Issued in MO

Practice address

123 Smith Ave
Sikeston, MO 63801-5239

Phone

(573) 471-0200

Fax

(573) 481-2209

NPI assigned

Jun 13, 2018

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Missouri Delta Medical Center

  • Internal Medicine Physician
  • Sikeston, MO
  • NPI 1508967860
  NPD
• Missouri Delta Medical Center

  • Community/Retail Pharmacy
  • Malden, MO
  • NPI 1578371621
  NPD
• Bootheel Counseling Services

  • Community/Behavioral Health Agency
  • Sikeston, MO
  • NPI 1700652898
  NPD (past)

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

{
    "created_epoch": "1528848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1316430440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 SMITH AVE",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638015239",
            "telephone_number": "573-471-0200",
            "fax_number": "573-481-2209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 SMITH AVE",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638015239",
            "telephone_number": "573-471-0200",
            "fax_number": "573-481-2209"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9979 Winghaven Blvd Ste 202",
            "address_purpose": "LOCATION",
            "city": "O Fallon",
            "state": "MO",
            "postal_code": "633683628",
            "country_code": "US",
            "telephone_number": "636-695-4554",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "760 Plantation Blvd",
            "address_purpose": "LOCATION",
            "city": "Sikeston",
            "state": "MO",
            "postal_code": "63801",
            "country_code": "US",
            "telephone_number": "573-471-0800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLYLE",
        "first_name": "BROOKE",
        "credential": "APRN, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-13",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2018019839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristina Buerschen
• Marcia Diane Buescher
• Faye Marie Burger, MA, LPC
• Eric Butler, D.O.
• Caring Hands in Home Care
• Joshua Carpenter
• Kristain Dru Carroll, CRNA
• Catholic Charities of Southern Missouri
• Catholic Charities of Southern Missouri for Mississippi Co
• Sherry L Chessor, CRNA

• Psychiatric/Mental Health Nurse Practitioner in Sikeston, MO
• Providers in Sikeston, MO by specialty
• Psychiatric/Mental Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.