Active NPI
Jamaal Clifton Brooks
- Case Manager/Care Coordinator
- Malden, MA
National Provider Identifier
1417213174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 167 Kennedy Dr
704
Malden, MA 02148-3467 - Phone
- (857) 222-9744
- NPI assigned
- Apr 6, 2012
- Last updated
- Apr 6, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | MA | Primary |
Addresses
Primary practice location
167 Kennedy Dr
704
Malden, MA 02148-3467
Mailing address
167 Kennedy Dr
704
Malden, MA 02148-3467
Phone (857) 222-9744
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1333670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1333670400000",
"number": "1417213174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "167 KENNEDY DR",
"address_2": "704",
"city": "MALDEN",
"state": "MA",
"postal_code": "021483467",
"telephone_number": "857-222-9744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "167 KENNEDY DR",
"address_2": "704",
"city": "MALDEN",
"state": "MA",
"postal_code": "021483467",
"telephone_number": "857-222-9744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOKS",
"first_name": "JAMAAL",
"middle_name": "CLIFTON",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-04-06",
"last_updated": "2012-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "MA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Malden, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.