Jimmette N Brooks, M.D.
Individual provider Active NPI Family Medicine Physician · Coventry, RI
NPI 1487005682 · NPPES record last updated Dec 13, 2019
Key facts
- NPI
- 1487005682
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- MD16412 (RI)
- Practice address
- 595 Washington St
Coventry, RI 02816-5476 - Phone
- (401) 822-2772
- Fax
- (401) 821-5260
- NPI assigned
- Jun 29, 2016
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in RI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200129001064 | RI | Practitioner - Family Practice | 2062741689 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Medicine Physician | 207Q00000X | MD16412 | RI | Yes |
Addresses
Primary practice location
595 Washington St
Coventry, RI 02816-5476
Mailing address
595 Washington St
Coventry, RI 02816-5476
Phone (401) 822-2772
Other practice location 1
110 Rehill Ave
Somerville, NJ 08876-2519
Phone (908) 685-2899
Other providers in Coventry, RI
- Tammy Jean Bonanno
- Janet M Bood
- Kathie A Bouchard
- Alyssa Boudreau
- Kayla Lynn Bourbon
- Bridget Brothers
- Amanda Brown
- Shawn Brown
- Meghan Kelly Broz
- Laura Elizabeth Brunero
All providers in Coventry, RI · Family Medicine Physician in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 13, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.