Individual provider Active NPI

Brooke Johnine Williams, NP

  • Family Nurse Practitioner
  • Monroe, LA
National Provider Identifier
1548912033
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
221915 Issued in LA
Practice address
111 Timberwood Dr
Monroe, LA 71203-2989
Phone
(318) 680-7856
NPI assigned
Jan 25, 2022
Last updated
Jan 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 221915 LA Primary

Addresses

Primary practice location

111 Timberwood Dr
Monroe, LA 71203-2989

Mailing address

111 Timberwood Dr
Monroe, LA 71203-2989
Phone (318) 680-7856

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20220215001783 LA Practitioner - Nurse Practitioner 0345633392 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minor Med Care, LLCGroup PAC ID 7618866021, shared by 2 NPIs, 77 clinicians
MDB Behavioral Health Services LLCGroup PAC ID 0749572915, 201 clinicians

Practice addresses (Care Compare)

120 W Main St
Raymond, MS 39154-1223
Phone (601) 857-2341

1911 Mission
66 Suite B
Vicksburg, MS 39180-3762
Phone (601) 456-2598

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
221915LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Louisiana Pain Care, LLC CurrentSince Jan 1, 2022 Accepting new patients
Signify Health, LLC CurrentSince Nov 1, 2023 Accepting new patients
Louisiana Pain Care, LLC CurrentSince Jan 1, 2022 Accepting new patients

Locations

210 Layton Ave
Monroe, LA 71201
Phone (318) 323-6405

210 Layton Ave
Ste 20
Monroe, LA 71201
Phone (318) 323-6405

201 Saint Charles Ave
Ste 2500
New Orleans, LA 70170
Phone (504) 224-6402

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: brooke.williams.p2@direct.lapaincare.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1643068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1548912033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 TIMBERWOOD DR",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712032989",
            "telephone_number": "318-680-7856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 TIMBERWOOD DR",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712032989",
            "telephone_number": "318-680-7856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "BROOKE",
        "middle_name": "JOHNINE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-25",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "221915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

Verify at the official NPI Registry.