Individual provider Active NPI

Laura-Jean Scott Brooks, NP

  • Family Nurse Practitioner
  • McComb, MS
National Provider Identifier
1316491012
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
901532 Issued in MS
Practice address
421 Marion Ave
McComb, MS 39648-2709
Phone
(601) 684-6891
Fax
(601) 249-3834
NPI assigned
Aug 10, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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 901532 MS Primary

Addresses

Primary practice location

421 Marion Ave
McComb, MS 39648-2709

Mailing address

PO Box 490
McComb, MS 39649-0490
Phone (601) 249-2701

Other identifiers 1

IdentifierTypeStateIssuer
05281873MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20160920001148 MS Practitioner - Nurse Practitioner 2668769621 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Mississippi, PLLC CurrentSince Oct 1, 2019 Accepting new patients
Keystone Medical Services of Ms, Inc CurrentSince Nov 1, 2017 Accepting new patients
Fast Pace Mississippi, PLLC Family CurrentSince Oct 1, 2019 Accepting new patients

Locations

1560 Sumrall Rd
Columbia, MS 39429
Phone (601) 736-6303

517 City Ave S
Ripley, MS 38663
Phone (662) 587-8206

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": "1470787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1316491012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396490490",
            "telephone_number": "601-249-2701",
            "fax_number": "601-249-2195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 MARION AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396482709",
            "telephone_number": "601-684-6891",
            "fax_number": "601-249-3834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT BROOKS",
        "first_name": "LAURA-JEAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-10",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "901532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05281873",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McComb, MS

Sources for this page

Verify at the official NPI Registry.