Brooke Boggs LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

BROOKE BOGGS LLC

Practice address

403 Lexington Cir
Grand Island, NE 68803-9728

Phone

(308) 227-6119

Fax

(308) 888-0018

NPI assigned

May 3, 2019

Organization subpart

No

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

Authorized official

Name

Brooke Nicole Boggs, APRN

Title

Owner/Provider

Phone

(308) 530-6569

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1556841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607558400000",
    "number": "1396300562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 LEXINGTON CIR",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688039728",
            "telephone_number": "308-227-6119",
            "fax_number": "308-888-0018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 LEXINGTON CIR",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688039728",
            "telephone_number": "308-227-6119",
            "fax_number": "308-888-0018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKE BOGGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-03",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A",
        "authorized_official_last_name": "BOGGS",
        "authorized_official_first_name": "BROOKE",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "308-530-6569",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50511752800",
            "state": "NE"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brooke@gimhmc.com",
            "affiliation": "N",
            "endpointDescription": "poaubox",
            "address_1": "1917 W Faidley Ave",
            "city": "Grand Island",
            "state": "NE",
            "country_code": "US",
            "postal_code": "688034642",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kellie Brittain, LPN
• Adam Brock
• Janelle Kay Brock, MSW,LCSW
• Debra Brockhaus
• Megan Broe
• Adam Benson Brosz, M.D.
• Rachel Lynn Brown McDonald, DDS
• Alaina R Brown
• Brenda Brown
• Jennifer Lee Brown, M.D.

• Primary Care Clinic/Center in Grand Island, NE
• Providers in Grand Island, NE by specialty
• Primary Care Clinic/Center in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; 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.