Individual provider Active NPI

Scherun Michelle Brooks, FNP

  • Nurse Practitioner
  • Corinth, MS
National Provider Identifier
1407120280
Registry record updated Aug 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R877563 Issued in MS
Practice address
2113 S Tate St
Corinth, MS 38834-7912
Phone
(662) 331-1497
Fax
(662) 331-1495
NPI assigned
Feb 27, 2012
Last updated
Aug 4, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R877563 MS Primary

Addresses

Primary practice location

2113 S Tate St
Corinth, MS 38834-7912

Mailing address

2668 S Harper Rd
Suite 1
Corinth, MS 38834-6770
Phone (662) 287-7138

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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

Enrollment IDStateProvider typePAC IDDetails
I20120924000173 MS Practitioner - Nurse Practitioner 7416105184 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brooks Medical ClinicGroup PAC ID 0749534170, 3 clinicians

Practice addresses (Care Compare)

2113 S Tate St
Corinth, MS 38834-7912
Phone (662) 331-1497

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R877563MSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Mississippi Emergency Physicians PA Past Accepting new patients

Organizations & group practices 2

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1330300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1407120280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2668 S HARPER RD",
            "address_2": "SUITE 1",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388346770",
            "telephone_number": "662-287-7138",
            "fax_number": "662-287-7157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2113 S TATE ST",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388347912",
            "telephone_number": "662-331-1497",
            "fax_number": "662-331-1495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "SCHERUN",
        "middle_name": "MICHELLE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-27",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R877563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corinth, MS

Sources for this page

Verify at the official NPI Registry.