Individual provider Active NPI

Brooke Elaine Kimbrell, MD

  • Pediatric Neurodevelopmental Disabilities Physician
  • Fort Worth, TX
National Provider Identifier
1568969566
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Neurodevelopmental Disabilities PhysicianTaxonomy code 2080P0008X
License
V1809 Issued in TX
Practice address
1500 Cooper St
Fort Worth, TX 76104-2710
Phone
(682) 303-9200
Fax
(682) 303-9245
NPI assigned
Apr 7, 2018
Last updated
Oct 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Neurodevelopmental Disabilities Physician 2080P0008X D0094523 MD
Pediatric Neurodevelopmental Disabilities Physician 2080P0008X V1809 TX Primary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X V1809 TX

Addresses

Primary practice location

1500 Cooper St
Fort Worth, TX 76104-2710

Mailing address

PO Box 733784
Dallas, TX 75373-3784
Phone (682) 885-6483

Other practice location 1

707 N Broadway
Baltimore, MD 21205-1888
Phone (433) 923-9200

Other practice location 2

22 S Greene St
Baltimore, MD 21201-1544
Phone (706) 525-9019

Other names 1

  • Brooke Elaine Schermerhorn Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bkimbrell216998@CookChildrens.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241024003876 TX Practitioner - Pediatric MedicinePractitioner - Neurology 8921432378 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0094523MDMDPediatric Neurodevelopmental Disabilities Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cook Children's Physician Network CurrentSince Sep 23, 2024 Accepting new patients
Cook Children's Physician Network Current Accepting new patients
Cook Children's Medical Center Past Accepting new patients

Locations

7000 Calmont Ave
Ste 150
Fort Worth, TX 76116
Phone (682) 885-6163

1500 Cooper St
Ft Worth, TX 76104
Phone (682) 885-2500

801 7th Ave
Ft Worth, TX 76104
Phone (682) 885-4054

136 El Chico Trl
Ste 102
Willow Park, TX 76087
Phone (817) 441-5412

Interoperability endpoints

  • Direct secure messaging: bkimbrell216998@cookchildrens.direct-ci.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1523059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1568969566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 733784",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753733784",
            "telephone_number": "682-885-6483",
            "fax_number": "682-885-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 COOPER ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042710",
            "telephone_number": "682-303-9200",
            "fax_number": "682-303-9245"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "707 N Broadway",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212051888",
            "country_code": "US",
            "telephone_number": "433-923-9200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "22 S Greene St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212011544",
            "country_code": "US",
            "telephone_number": "706-525-9019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIMBRELL",
        "first_name": "BROOKE",
        "middle_name": "ELAINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-07",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neurodevelopmental Disabilities",
            "state": "MD",
            "license": "D0094523",
            "primary": false
        },
        {
            "code": "2080P0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neurodevelopmental Disabilities",
            "state": "TX",
            "license": "V1809",
            "primary": true
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "TX",
            "license": "V1809",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bkimbrell216998@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "1500 Cooper St",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761042710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "BROOKE",
            "last_name": "SCHERMERHORN",
            "middle_name": "ELAINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.