Individual provider Active NPI

Lynnette Brookes, R.N

  • Pediatric Registered Nurse
  • Spencerport, NY
National Provider Identifier
1366726671
Registry record updated Oct 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Registered NurseTaxonomy code 163WP0200X
License
7532570 Issued in NY
Practice address
3599 Big Ridge Rd
Spencerport, NY 14559-1709
Phone
(585) 352-2400
NPI assigned
Oct 5, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X 7532570 NY Primary

Addresses

Primary practice location

3599 Big Ridge Rd
Spencerport, NY 14559-1709

Mailing address

55 Union Station Rd
North Chili, NY 14514-9742
Phone (585) 889-6562

Other identifiers 1

IdentifierTypeStateIssuer
0725LMBMedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
7532570NYMDPediatric Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Boces2 Past Accepting new patients

Organizations & group practices 1

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": "1317772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317772800000",
    "number": "1366726671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 UNION STATION RD",
            "city": "NORTH CHILI",
            "state": "NY",
            "postal_code": "145149742",
            "telephone_number": "585-889-6562",
            "fax_number": "585-889-6562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3599 BIG RIDGE RD",
            "city": "SPENCERPORT",
            "state": "NY",
            "postal_code": "145591709",
            "telephone_number": "585-352-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKES",
        "first_name": "LYNNETTE",
        "name_prefix": "Mrs.",
        "credential": "R.N",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-05",
        "last_updated": "2011-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "NY",
            "license": "7532570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0725LMB",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spencerport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2011; 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.