John Marshall Brooke, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

OH15402 Issued in OH

Practice address

250 S Chestnut St
Ravenna, OH 44266-3031

Phone

(330) 297-7009

NPI assigned

Dec 5, 2006

Sex

Male

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

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280361600000",
    "number": "1497813935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 S CHESTNUT ST",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442663031",
            "telephone_number": "330-297-7009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 S CHESTNUT ST",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442663031",
            "telephone_number": "330-297-7009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKE",
        "first_name": "JOHN",
        "middle_name": "MARSHALL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2010-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "OH15402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0468597",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Juli Ann Bretti, NP
• Jennifer Lynn Breznai
• Tabatha Ann Briggs, OTA
• Brianna Nicole Bright, CNP
• Todd Michael Bright, PHARMD.
• Jennifer Brown-Reese
• Antoinette Brown
• Brittany Brown
• Chinese Riketta Jade Brown, PMHNP
• Cierra Brown

• General Practice Dentistry in Ravenna, OH
• Providers in Ravenna, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2010; 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.