Individual provider Active NPI

Brooke Lacy Garner

  • Primary Care Nurse Practitioner
  • Dyersburg, TN
National Provider Identifier
1518475656
Registry record updated Jun 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
F12170551 Issued in TN
Practice address
2550 Parr Ave
Dyersburg, TN 38024
Phone
(731) 325-5678
NPI assigned
Jan 10, 2018
Last updated
Jun 19, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2018

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 23738 TN
Primary Care Nurse Practitioner 363LP2300X F12170551 TN Primary

Addresses

Primary practice location

2550 Parr Ave
Dyersburg, TN 38024

Mailing address

2550 Parr Ave
Dyersburg, TN 38024-2033
Phone (731) 325-5678

Other practice location 1

327 Summar Dr
Jackson, TN 38301-3930
Phone (731) 423-8200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20180829004759 TN Practitioner - Nurse Practitioner 8820348535 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Group practices
Hometown Urgent Care of Dyersburg, PLLCGroup PAC ID 8820349202, 8 clinicians

Practice addresses (Care Compare)

2550 Parr Ave
Dyersburg, TN 38024-2033
Phone (731) 325-5678

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F12170551TNMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hometown Urgent Care of Dyersburg PLLC CurrentSince Aug 29, 2018 Accepting new patients
Apex Cardiology PC CurrentSince May 21, 2018 Accepting new patients
Apex Cardiology PC CurrentSince May 21, 2018 Accepting new patients

Locations

2550 Parr Ave
Dyersburg, TN 38024
Phone (731) 325-5678

327 Summar Dr
Jackson, TN 38301
Phone (731) 325-5678

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1515542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529366400000",
    "number": "1518475656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 PARR AVE",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380242033",
            "telephone_number": "731-325-5678",
            "fax_number": "731-325-5679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 PARR AVE",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "38024",
            "telephone_number": "731-325-5678"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "327 Summar Dr",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "TN",
            "postal_code": "383013930",
            "country_code": "US",
            "telephone_number": "731-423-8200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARNER",
        "first_name": "BROOKE",
        "middle_name": "LACY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-10",
        "last_updated": "2018-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "23738",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TN",
            "license": "F12170551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dyersburg, TN

Sources for this page

Verify at the official NPI Registry.