Individual provider Active NPI

Brooke Marie Jones, APRN-C

  • Family Nurse Practitioner
  • Leawood, KS
National Provider Identifier
1497168041
Registry record updated Dec 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5376259101 Issued in KS
Practice address
12256 State Line Rd.
Leawood, KS 66209
Phone
(913) 345-9888
Fax
(913) 345-0958
NPI assigned
Jun 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5376259101 KS Primary
Registered Nurse 163W00000X 13-111661-101 KS

Addresses

Primary practice location

12256 State Line Rd.
Leawood, KS 66209

Mailing address

12256 State Line Rd.
Leawood, KS 66209
Phone (913) 345-9888

Other identifiers 1

IdentifierTypeStateIssuer
KA3281001OtherKSMEDICARE PTAN

Other names 1

  • Miss Brooke Marie McGovern Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140714000595 KS Practitioner - Nurse Practitioner 3173748829
I20150328000136 MO Practitioner - Nurse Practitioner 3173748829 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13-111661-101KSMDRegistered Nurse
5376259101KSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Restore Muscle and Joint, LLC CurrentSince Jan 23, 2015 Accepting new patients
Shane Bisson Chiropractic PA Current Accepting new patients
Acute Spinal Rehab PA PastSince May 1, 2016 Accepting new patients

Locations

12100 State Line Rd
Leawood, KS 66209
Phone (316) 882-5353

12256 State Line Rd
Leawood, KS 66209
Phone (913) 345-9888

5601 N Antioch Rd
Ste 7
Kansas City, MO 64119
Phone (816) 452-4488

4119 NW Barry Rd
Kansas City, MO 64154
Phone (816) 452-4488

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1402358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417651200000",
    "number": "1497168041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12256 STATE LINE RD.",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "66209",
            "telephone_number": "913-345-9888",
            "fax_number": "913-345-0958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12256 STATE LINE RD.",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "66209",
            "telephone_number": "913-345-9888",
            "fax_number": "913-345-0958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "BROOKE",
        "middle_name": "MARIE",
        "credential": "APRN-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-10",
        "last_updated": "2014-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "5376259101",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KS",
            "license": "13-111661-101",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "KA3281001",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BROOKE",
            "last_name": "MCGOVERN",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "credential": "APRN-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Leawood, KS

Sources for this page

Verify at the official NPI Registry.