Active NPI
Dustin Corey Brooks, PA-C
- Medical Physician Assistant
- Lawton, OK
National Provider Identifier
1477060457
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 2731
- Practice address
- 6744 NW Cache Rd
Lawton, OK 73505-2702 - Phone
- (580) 536-9355
- NPI assigned
- Dec 29, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 2731 | OK | Primary |
Addresses
Primary practice location
6744 NW Cache Rd
Lawton, OK 73505-2702
Mailing address
1832 Parkridge Dr
Norman, OK 73071-1301
Phone (405) 818-2451
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2731 | OK | MD | Professional Counselor |
Interoperability endpoints
- dustinbrooks@okss.allscriptsdirect.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1514505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1514505600000",
"number": "1477060457",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1832 PARKRIDGE DR",
"city": "NORMAN",
"state": "OK",
"postal_code": "730711301",
"telephone_number": "405-818-2451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6744 NW CACHE RD",
"city": "LAWTON",
"state": "OK",
"postal_code": "735052702",
"telephone_number": "580-536-9355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOKS",
"first_name": "DUSTIN",
"middle_name": "COREY",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-12-29",
"last_updated": "2017-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physician Assistant, Medical",
"state": "OK",
"license": "2731",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawton, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2017; 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.