Individual provider Active NPI

Kusanya Amice Brooks, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Supply, NC
National Provider Identifier
1427314566
Registry record updated Jul 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5022307 Issued in NC
Practice address
6 Doctors Cir Ste 1
Supply, NC 28462-6358
Phone
(910) 754-4233
NPI assigned
Apr 3, 2012
Last updated
Jul 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5022307 NC Primary
Registered Nurse 163W00000X 648549 NY

Addresses

Primary practice location

6 Doctors Cir Ste 1
Supply, NC 28462-6358

Mailing address

615 Shipyard Blvd
Wilmington, NC 28412-6431
Phone (910) 343-0145

Other practice location 1

1806 S 15th St
Wilmington, NC 28401-6479
Phone (910) 772-2515

Other practice location 2

1496 Hwy 701 N
Elizabethtown, NC 28412
Phone (910) 202-3155

Other practice location 3

309 Progress Dr
Burgaw, NC 28425-3280
Phone (910) 259-0668

Other practice location 4

1414 Medical Center Dr
Wilmington, NC 28401-7505
Phone (910) 790-9949

Other practice location 5

615 Shipyard Blvd
Wilmington, NC 28412-6431
Phone (910) 343-0145

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20260113000982 NC Practitioner - Nurse Practitioner 7810473519 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Horizons Center, Inc.Group PAC ID 9739267964, 50 clinicians

Practice addresses (Care Compare)

1240 Huffman Mill Rd
Burlington, NC 27215-8700
Phone (336) 538-7000

615 Shipyard Blvd
Wilmington, NC 28412-6431
Phone (910) 343-0145

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
648549NYMDRegistered Nurse
5022307NCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Horizons Center, Inc CurrentSince Dec 2, 2025 Accepting new patients
Coastal Horizons Center Inc CurrentSince Dec 2, 2025 Accepting new patients
Coastal Horizons Center, Inc. Current Accepting new patients
County of Monroe Past Accepting new patients
Monroe County Health Department Past Accepting new patients

Locations

309 Progress Dr
Burgaw, NC 28425
Phone (910) 259-0445

120 Coastal Horizons Dr
Shallotte, NC 28470
Phone (910) 754-4515

1414 Medical Center Dr
Wilmington, NC 28401
Phone (910) 763-7363

1806 S 15th St
Wilmington, NC 28401
Phone (252) 243-4450

615 Shipyard Blvd
Wilmington, NC 28412
Phone (910) 202-5709

Organizations & group practices 8

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": "1333411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753142400000",
    "number": "1427314566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 SHIPYARD BLVD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284126431",
            "telephone_number": "910-343-0145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 DOCTORS CIR STE 1",
            "city": "SUPPLY",
            "state": "NC",
            "postal_code": "284626358",
            "telephone_number": "910-754-4233"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1806 S 15th St",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284016479",
            "country_code": "US",
            "telephone_number": "910-772-2515",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1496 Hwy 701 N",
            "address_purpose": "LOCATION",
            "city": "Elizabethtown",
            "state": "NC",
            "postal_code": "28412",
            "country_code": "US",
            "telephone_number": "910-202-3155",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "309 Progress Dr",
            "address_purpose": "LOCATION",
            "city": "Burgaw",
            "state": "NC",
            "postal_code": "284253280",
            "country_code": "US",
            "telephone_number": "910-259-0668",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1414 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284017505",
            "country_code": "US",
            "telephone_number": "910-790-9949",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "615 Shipyard Blvd",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284126431",
            "country_code": "US",
            "telephone_number": "910-343-0145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "KUSANYA",
        "middle_name": "AMICE",
        "name_prefix": "Ms.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-03",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5022307",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "648549",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Supply, NC

Sources for this page

Verify at the official NPI Registry.