Nicole Brockman, PNP, MSN, BSN

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

2021009743 Issued in MO

Practice address

4400 Clayton Ave
Saint Louis, MO 63110-1624

Phone

(314) 432-3600

NPI assigned

Aug 16, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Bachelor on Science - Nursing, Master of Science - Nursing, Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Shriners Hospitals for Children

  • Pediatric Orthopaedic Surgery Physician
  • Saint Louis, MO
  • NPI 1275970295
  Medicare reassignment NPD
• Shriners Hospitals for Children

  dba Shriners Children's Hawaii

  • Clinic/Center
  • Aiea, HI
  • NPI 1568299857
  NPD
• Shriners Hospitals for Children

  • Pediatric Orthopaedic Surgery Physician
  • Shreveport, LA
  • NPI 1568803732
  NPD (past)

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

{
    "created_epoch": "1660608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1467170472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 FOX MDWS",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271448",
            "telephone_number": "314-495-4656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 CLAYTON AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101624",
            "telephone_number": "314-432-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKMAN",
        "first_name": "NICOLE",
        "credential": "PNP, MSN, BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-16",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "2021009743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa L. Brock, APRN
• Tonya M Brock, CRNA
• Tiffany Kay Brocke, MD
• Tilford A. Brockett Jr.
• Laurie Katherine Brockhaus, LCSW
• Andrea Brockmann, PHD
• Karen Brockmann, R.N.
• Gina Belfiore Brockmeier, FNP
• Megan E Brockmeier, AUD
• Nathan Robert Brockmeier, PHARM D

• Pediatric Nurse Practitioner in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Pediatric Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; 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.