Pam Lynn Brokaw-Myers, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN.CNP 020349 Issued in OH

Practice address

500 Lincoln Park Blvd Ste 110
Kettering, OH 45429-6410

Phone

(937) 531-5020

Fax

(937) 298-4385

NPI assigned

May 5, 2017

Last updated

Nov 23, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mrs. Pam Lynn Myers Other name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in OH

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

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Alliance Physicians IncGroup PAC ID 0840104360, 314 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kettering Homecare Home health agency, Kettering, OH, CCN 367778
• Kettering Health Main Campus Hospital, Kettering, OH, CCN 360079
• Kettering Health Dayton Hospital, Dayton, OH, CCN 360133
• Kettering Health Miamisburg Hospital, Miamisburg, OH, CCN 360239
• Soin Medical Center Hospital, Beaver Creek, OH, CCN 360360

Medicare enrollment (NPD)

Enrolled

Credentials

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

• Alliance Physicians Inc

  dba Kettering Health Medical Group

  • Family Medicine Physician
  • Kettering, OH
  • NPI 1437125572
  Medicare reassignment Care Compare group NPD
• Alliance Physicians Inc

  dba Kemp Road Family Practice

  • Family Medicine Physician
  • Beavercreek, OH
  • NPI 1891049722
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Alternate Solutions Homecare of Dayton, LLC

  • Home Health Agency
  • Kettering, OH
  • NPI 1639195332
  Care Compare affiliation
• Beavercreek Medical Center

  dba Soin Medical Center

  • General Acute Care Hospital
  • Beavercreek, OH
  • NPI 1760764849
  Care Compare affiliation
• Dayton Osteopathic Hospital

  dba Kettering Health Dayton

  • General Acute Care Hospital
  • Dayton, OH
  • NPI 1053339507
  Care Compare affiliation
• Kettering Medical Center

  dba Kettering Health Main Campus

  • General Acute Care Hospital
  • Kettering, OH
  • NPI 1043233984
  Care Compare affiliation
• Kettering Medical Center

  dba Kettering Health Miamisburg

  • General Acute Care Hospital
  • Miamisburg, OH
  • NPI 1316966518
  Care Compare affiliation

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

{
    "created_epoch": "1493942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1467988790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 LINCOLN PARK BLVD STE 110",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454296410",
            "telephone_number": "937-531-5020",
            "fax_number": "937-298-4385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 LINCOLN PARK BLVD STE 110",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454296410",
            "telephone_number": "937-531-5020",
            "fax_number": "937-298-4385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROKAW-MYERS",
        "first_name": "PAM",
        "middle_name": "LYNN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-05",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP 020349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0232002",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pbrokawmyers595522@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "500 Lincoln Park Blvd Ste 110",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454296410",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "500 Lincoln Park Blvd Ste 110",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454296410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "PAM",
            "last_name": "MYERS",
            "middle_name": "LYNN",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Holly Broach, OTR/L
• Kenneth W Brock, MD
• Tiffani Brock
• Loren Brockert, LMT NCTMB
• Derek Lee Broering, MD
• Suzanne Marie Brooks, RN, MS, CNS-BC
• Aisha Brothers, MSW, LISW
• David M Brouhard, MD
• Kerry Brower, IHP
• Keri Brown Kirschman, PH.D.

• Family Nurse Practitioner in Kettering, OH
• Providers in Kettering, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; 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.