NPIMap

Individual provider Active NPI

Brooke Ashley Wethington, PA-C

  • Physician Assistant
  • Foley, AL
National Provider Identifier
1427593680
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8224 Issued in GA
Practice address
22394 Miflin Rd Ste 104
Foley, AL 36535-9593
Phone
(251) 318-0053
Fax
(251) 215-6731
NPI assigned
Dec 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 8224 GA Primary

Addresses

Primary practice location

22394 Miflin Rd Ste 104
Foley, AL 36535-9593

Mailing address

1706 Washington Way
PO Box 1338
Longview, WA 98632-1701
Phone (360) 423-0390

Other identifiers 3

IdentifierTypeStateIssuer
PA.60855522OtherWAWA STATE LICENSE NUMBER
1136537OtherGANCCPA
8224OtherGAPA LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, WA, AL3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20170214001606 GA Practitioner - Physician Assistant 7012290216 Reassigns benefits to 1 organization
I20180702001554 WA Practitioner - Physician Assistant 7012290216 Reassigns benefits to 1 organization
I20230621002257 AL Practitioner - Physician Assistant 7012290216 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Lincoln Memorial University Medical Department, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
National Family Medical Associates of Alabama, LLCGroup PAC ID 2163879776, 18 clinicians

Practice addresses (Care Compare)

22394 Miflin Rd
Suite 104
Foley, AL 36535-9593
Phone (251) 444-1999

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
008224GAMDSurgery Physician
8224GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kirkpatrick Family Care, PS CurrentSince Jun 5, 2018 Accepting new patients

Locations

1706 Washington Way
Longview, WA 98632
Phone (360) 423-9580

Interoperability endpoints

  • Direct secure messaging: bwethington@landmarkhealth-direct.org
  • Direct secure messaging: brooke.wethington@vt.eclinicaldirectplus.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1482796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1427593680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 WASHINGTON WAY",
            "address_2": "PO BOX 1338",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986321701",
            "telephone_number": "360-423-0390",
            "fax_number": "360-423-6230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22394 MIFLIN RD STE 104",
            "city": "FOLEY",
            "state": "AL",
            "postal_code": "365359593",
            "telephone_number": "251-318-0053",
            "fax_number": "251-215-6731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WETHINGTON",
        "first_name": "BROOKE",
        "middle_name": "ASHLEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-27",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "8224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA STATE LICENSE NUMBER",
            "identifier": "PA.60855522",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA",
            "identifier": "1136537",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE NUMBER",
            "identifier": "8224",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Foley, AL

Sources for this page

Verify at the official NPI Registry.