Individual provider Active NPI

Gabrielle Brogan, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Manhattan, KS
National Provider Identifier
1417795303
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
53-833384-071 Issued in KS
Practice address
1133 College Ave Building a
Suite A213
Manhattan, KS 66502
Phone
(785) 775-0221
NPI assigned
Jul 16, 2024
Last updated
Jul 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 53-833384-071 KS Primary

Addresses

Primary practice location

1133 College Ave Building a
Suite A213
Manhattan, KS 66502

Mailing address

1133 College Ave Building a
Suite A213
Manhattan, KS 66502
Phone (785) 775-0221

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20240909003654 KS Practitioner - Nurse Practitioner 1052851755 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Freedom Behavioral Health Solutions LLCGroup PAC ID 3577909431, 13 clinicians

Practice addresses (Care Compare)

1133 College Ave
Suite E110
Manhattan, KS 66502-2813
Phone (785) 775-0221

1133 College Ave BLD E
Suite 110
Manhattan, KS 66502-2781

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
53-833384-071KSMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Freedom Behavioral Health Solutions, LLC CurrentSince Aug 1, 2024 Accepting new patients

Locations

1133 College Ave
Ste A213
Manhattan, KS 66502
Phone (785) 587-1825

1133 College Ave
Ste E110
Manhattan, KS 66502
Phone (785) 537-2651

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1721088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1417795303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 COLLEGE AVE BUILDING A",
            "address_2": "SUITE A213",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "66502",
            "telephone_number": "785-775-0221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 COLLEGE AVE BUILDING A",
            "address_2": "SUITE A213",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "66502",
            "telephone_number": "785-775-0221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROGAN",
        "first_name": "GABRIELLE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-16",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KS",
            "license": "53-833384-071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhattan, KS

Sources for this page

Verify at the official NPI Registry.