Brooke Nicole Fletcher

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

PA58156 Issued in CA

Practice address

2633 Pacific Ave
Stockton, CA 95204-4429

Phone

(209) 944-5530

NPI assigned

Jun 4, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JDABCA/Endpoint/JDABCA

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.

• Manshadi Heart Institute Inc

  • Interventional Cardiology Physician
  • Stockton, CA
  • NPI 1225380603
  Medicare reassignment

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

{
    "created_epoch": "1591228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591660800000",
    "number": "1538783519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2633 PACIFIC AVE",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952044429",
            "telephone_number": "209-944-5530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2633 PACIFIC AVE",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952044429",
            "telephone_number": "209-944-5530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "BROOKE",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-04",
        "last_updated": "2020-06-09",
        "certification_date": "2020-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "PA58156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharee Fitzgerald
• Five Star Quality Care-Ca II LLC (La Salette Health and Rehabilitation Center)
• Five Star Rio Las Palmas LLC (The Courtyard at Rio Las Palmas)
• Deborah Sue Flanary
• Liandra Victoria Fleming
• Kaelin Sierra Fletcher
• Amanda Sue Flolo
• Estrella Denise Flores Macedo
• Erika Jasmine Flores Robles
• Andrea Guadalupe Flores Sanchez

• Cardiovascular Disease Physician in Stockton, CA
• Providers in Stockton, CA by specialty
• Cardiovascular Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2020; 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.