Amy Jo Brokaw, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

119768-MEDS Issued in OH

Practice address

43 Kennedy Dr
Caldwell, OH 43724-9004

Phone

(740) 732-5211

Fax

(740) 732-4175

NPI assigned

Jul 28, 2015

Last updated

Jul 28, 2015By the provider in NPPES

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• TLC Complete Home Care, Inc.

  • Home Health Agency
  • Caldwell, OH
  • NPI 1215050828
  NPD (past)
• TLC Home Health Care, Inc.

  • Home Health Agency
  • Caldwell, OH
  • NPI 1750404372
  NPD (past)

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

{
    "created_epoch": "1438041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438041600000",
    "number": "1396120671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 KENNEDY DR",
            "city": "CALDWELL",
            "state": "OH",
            "postal_code": "437249004",
            "telephone_number": "740-732-5211",
            "fax_number": "740-732-4175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 KENNEDY DR",
            "city": "CALDWELL",
            "state": "OH",
            "postal_code": "437249004",
            "telephone_number": "740-732-5211",
            "fax_number": "740-732-4175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROKAW",
        "first_name": "AMY",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-28",
        "last_updated": "2015-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "119768-MEDS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0136187",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Braden Med Services, Inc
• Braden Med Services, Inc.
• Braden Med SVS Inc (Gillespies Drugs)
• James Scott Braden, RPH
• Yvonne Renee Braden, L.P.N.
• Stephanie Bryan
• Roxann Lynn Bryant, AAS, QMHS
• Caldwell Clinic
• Caldwell Exempted Village School District
• Savanah Clipner, AAS,QMHS

• Licensed Practical Nurse in Caldwell, OH
• Providers in Caldwell, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2015; 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.