Brooke Amber Hasenfelt

Primary specialty

DentistTaxonomy code 122300000X

License

150907 Issued in NC

Practice address

100 Health Center Dr
Ahoskie, NC 27910-8161

Phone

(252) 737-7200

NPI assigned

Jan 7, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Brooke Amber Jordan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jun 10, 2016 through Jun 10, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1357516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357516800000",
    "number": "1376880781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2117 LIVINGSTON ST",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234353292",
            "telephone_number": "262-385-1628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HEALTH CENTER DR",
            "city": "AHOSKIE",
            "state": "NC",
            "postal_code": "279108161",
            "telephone_number": "252-737-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASENFELT",
        "first_name": "BROOKE",
        "middle_name": "AMBER",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-07",
        "last_updated": "2013-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "150907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BROOKE",
            "last_name": "JORDAN",
            "middle_name": "AMBER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Terry Cornelius Hall, D.M.D.
• Jolynn Harrell, CDE
• Shanta Harrell
• Sue Ann Harrison, COTA/L
• Kelby Lewis Harrup, PA-C
• Brad E Hauser, O.D.
• Deja Jahmi Hawkins
• Health Services Personnel
• Healthcare Resources Group LLC
• Gerwyn Evans Heath, LPA

• Dentist in Ahoskie, NC
• Providers in Ahoskie, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2013; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.