Individual provider Active NPI

Erin Rachael Brooks, PA

  • Physician Assistant
  • Ridgeland, MS
National Provider Identifier
1447980107
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA00616 Issued in MS
Practice address
204 W Jackson St Ste B
Ridgeland, MS 39157-2310
Phone
(601) 636-7222
Fax
(601) 636-0440
NPI assigned
Jun 15, 2022
Last updated
Jun 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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 PA00616 MS Primary

Addresses

Primary practice location

204 W Jackson St Ste B
Ridgeland, MS 39157-2310

Mailing address

106 Windy Lake Cir
Vicksburg, MS 39183-1115
Phone (601) 415-0678

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20240830002260 MS Practitioner - Physician Assistant 1759820962 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trustcare Health, LLCGroup PAC ID 0547427858, 40 clinicians

Practice addresses (Care Compare)

1051 Highland Colony Pkwy
Suite E
Ridgeland, MS 39157-7701
Phone (601) 707-3737

1710 Old Fannin Rd
Flowood, MS 39232-9004
Phone (601) 487-9191

601 Hwy 80 E
Clinton, MS 39056-5122
Phone (601) 708-1480

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA00616MSMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Trustcare Primary Care, LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: erin.brooks.1@19538.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1655251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1447980107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 WINDY LAKE CIR",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391831115",
            "telephone_number": "601-415-0678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 W JACKSON ST STE B",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391572310",
            "telephone_number": "601-636-7222",
            "fax_number": "601-636-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "ERIN",
        "middle_name": "RACHAEL",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-15",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MS",
            "license": "PA00616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgeland, MS

Sources for this page

Verify at the official NPI Registry.