Kevin Brooks, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA1143 Issued in KY

Practice address

272 London Mountain View Dr
London, KY 40741-6601

Phone

(606) 877-2850

Fax

(606) 877-2857

NPI assigned

Sep 23, 2008

Last updated

Sep 17, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in KY

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, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grace Community Health Center, Inc.Group PAC ID 3870654064, 65 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kbrooks704176@direct.ochin.org

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.

• Grace Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Corbin, KY
  • NPI 1568625648
  Medicare reassignment Care Compare group
• Grace Community Health Center Inc

  dba Hyden Clinic

  • Federally Qualified Health Center (FQHC)
  • Hyden, KY
  • NPI 1598207557
  NPD
• Grace Community Health Center, Inc.

  dba Grace Health

  • Federally Qualified Health Center (FQHC)
  • Corbin, KY
  • NPI 1316645344
  NPD

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

{
    "created_epoch": "1222128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1447400775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 LONDON MOUNTAIN VIEW DR",
            "address_2": "SUITE 3",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407416617",
            "telephone_number": "606-877-2850",
            "fax_number": "606-877-2857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "272 LONDON MOUNTAIN VIEW DR",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407416601",
            "telephone_number": "606-877-2850",
            "fax_number": "606-877-2857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "KEVIN",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-23",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KY",
            "license": "PA1143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000592078",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KY LICENSE",
            "identifier": "PA1143",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHI",
            "identifier": "S60507",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100112880",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dereni Blake Brock, PT
• Jessica Marie Brock, APRN
• Nadine Brock, APRN
• Olivia Anne Brock, CRNA
• Stephanie Ann Brock, LCADC
• Marietta Brooks, APRN
• Sheila Brooks
• Zachary Michael Broughton, PMHNP-BC
• Donald Edward Brown, M.D.
• James Michael Brown, D.O.

• Medical Physician Assistant in London, KY
• Providers in London, KY by specialty
• Medical Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2019; 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.