Haven Shaye Brolsma, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-157639 Issued in AL

Practice address

101 Ivory PL
Madison, AL 35758-2349

Phone

(256) 325-0236

NPI assigned

Nov 22, 2020

Last updated

Apr 28, 2022By 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

Enrolled in AL

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Empower2, LLCGroup PAC ID 6103185145, 13 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Empower2, LLC.

  dba approxie health

  • Urgent Care Clinic/Center
  • Madison, AL
  • NPI 1669985503
  Medicare reassignment Care Compare group NPD
• Blossomwood Medical PC

  dba Blossomwood Medical

  • Internal Medicine Physician
  • Huntsville, AL
  • NPI 1144451311
  NPD (past)

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

{
    "created_epoch": "1606003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651104000000",
    "number": "1316541287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2926 COUNTY ROAD 143",
            "city": "BREMEN",
            "state": "AL",
            "postal_code": "350337031",
            "telephone_number": "256-590-1502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 IVORY PL",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357582349",
            "telephone_number": "256-325-0236"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1908 Cherokee Ave SW",
            "address_purpose": "LOCATION",
            "city": "Cullman",
            "state": "AL",
            "postal_code": "350555502",
            "country_code": "US",
            "telephone_number": "256-736-1460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROLSMA",
        "first_name": "HAVEN",
        "middle_name": "SHAYE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-22",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-157639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bright Smiles Dental Inc
• Bright Way Mental Health, LLC
• Brightstarts Pediatrics PC
• Lawren Brinley, PA
• Abigail Lynn Brock, CRNP
• Erika Beth Brooks
• Julie Nicole Brooks, BS
• Cheneka Brown, LPC
• Haley Brown
• Lateska Tynesha Brown, MSW

• Family Nurse Practitioner in Madison, AL
• Providers in Madison, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.