Kaitlyn Frances Brokaw, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN2292936 Issued in MA

Practice address

326 Nichols Rd
Fitchburg, MA 01420-1914

Phone

(978) 878-8100

Fax

(978) 878-8537

NPI assigned

Jul 11, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 7

Addresses

Other names 1

• Kaitlyn Frances McCoy Other name

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Community Health Connections, Inc.

  • Federally Qualified Health Center (FQHC)
  • Fitchburg, MA
  • NPI 1477580827
  Medicare reassignment
• Community Health Connections, Inc.

  • Federally Qualified Health Center (FQHC)
  • Gardner, MA
  • NPI 1225742174
  NPD
• Community Health Connections, Inc.

  • Federally Qualified Health Center (FQHC)
  • Gardner, MA
  • NPI 1285630533
  NPD
• Community Health Connections, Inc.

  • Federally Qualified Health Center (FQHC)
  • Fitchburg, MA
  • NPI 1811149586
  NPD (past)

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

{
    "created_epoch": "1373500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439337600000",
    "number": "1457792939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 NICHOLS RD",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "01420",
            "telephone_number": "978-878-8100",
            "fax_number": "978-878-8537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 NICHOLS RD",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014201914",
            "telephone_number": "978-878-8100",
            "fax_number": "978-878-8537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROKAW",
        "first_name": "KAITLYN",
        "middle_name": "FRANCES",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-11",
        "last_updated": "2015-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2292936",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2292936",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN634919",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR16441600",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DE",
            "license": "L10042610",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NH",
            "license": "069276-21",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "069276-23",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLYN",
            "last_name": "MCCOY",
            "middle_name": "FRANCES",
            "credential": "MSN, FNP-BC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Judith D. Bralove, MSW, LICSW
• Hannah Brassard
• Leonard Marshall Brassard
• Michael Brennan
• Brennecke Acupuncture, P.C.
• Brooke Chamberland, Licsw
• Ramona E Brow, CNA
• Alicia Brown
• Felicia Brown, LMHC
• Jaclyn Brown, RN

• Family Nurse Practitioner in Fitchburg, MA
• Providers in Fitchburg, MA by specialty
• Family Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.