Bronwyn A Brocklehurst, MPAS, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110008085 Issued in VA

Practice address

79 N Medical Park Dr
Fishersville, VA 22939-2344

Phone

(540) 213-2525

Fax

(540) 213-2555

NPI assigned

May 5, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA

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

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Augusta Medical GroupGroup PAC ID 3678632544, 409 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bronwyn.brocklehurst.1@14718.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/14718/brand/4/csg/1/fhir/r4

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.

• Augusta Medical Group

  • General Practice Physician
  • Fishersville, VA
  • NPI 1245489590
  Medicare reassignment Care Compare group NPD
• Rockingham Memorial Hospital

  dba East Rockingham DME

  • Durable Medical Equipment & Medical Supplies
  • Elkton, VA
  • NPI 1952563827
  NPD (past)

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

{
    "created_epoch": "1620172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1407430549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 388",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229390388",
            "telephone_number": "540-932-5275",
            "fax_number": "540-932-5875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 N MEDICAL PARK DR",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229392344",
            "telephone_number": "540-213-2525",
            "fax_number": "540-213-2555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "78 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Fishersville",
            "state": "VA",
            "postal_code": "229392332",
            "country_code": "US",
            "telephone_number": "540-332-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 Kiln Dr",
            "address_purpose": "LOCATION",
            "city": "Rockingham",
            "state": "VA",
            "postal_code": "228018581",
            "country_code": "US",
            "telephone_number": "540-208-1867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROCKLEHURST",
        "first_name": "BRONWYN",
        "middle_name": "A",
        "credential": "MPAS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-05",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA062367",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA005610",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110008085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bronwyn.brocklehurst.1@14718.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging Address",
            "address_1": "79 N Medical Park Dr",
            "city": "Fishersville",
            "state": "VA",
            "country_code": "US",
            "postal_code": "229392344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Matthew Todd Brandt, DDS MD
• Jack Louis Breaux III, M.D.
• Mary L Breister, O.T.
• Anne Brie, O.T.
• Alan A Brijbassie, MD
• Candice Nicole Bronez
• Courtney Brooks
• Mark Brooks, M.D.
• Michelle A. Brooks, M.D.
• Bonnie Brown, RD

• Physician Assistant in Fishersville, VA
• Providers in Fishersville, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.