Active NPI
Mark F Brooks, MD
- Family Medicine Physician
- University Place, WA
National Provider Identifier
1598798480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD00031603
- Practice address
- 7210 40TH St W
Ste 100
University Place, WA 98466-4318 - Phone
- (253) 564-0170
- NPI assigned
- Jul 7, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD00031603 | WA | Primary |
Addresses
Primary practice location
7210 40TH St W
Ste 100
University Place, WA 98466-4318
Mailing address
7210 40TH St W
Ste 100
University Place, WA 98466-4318
Phone (253) 564-0170
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0126533 | Other | WA | STATE L&I |
| 8928712 | Other | WA | STATE CRIME VICTIMS |
| 8937675 | Other | WA | STATE CRIME VICTIMS |
| 0163664 | Other | WA | STATE L&I |
| 8154320 | Medicaid | WA | |
| 80138476 | Other | WA | MEDICARE RAILROAD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00031603 | WA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289865600000",
"number": "1598798480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7210 40TH ST W",
"address_2": "STE 100",
"city": "UNIVERSITY PLACE",
"state": "WA",
"postal_code": "984664318",
"telephone_number": "253-564-0170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7210 40TH ST W",
"address_2": "STE 100",
"city": "UNIVERSITY PLACE",
"state": "WA",
"postal_code": "984664318",
"telephone_number": "253-564-0170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOKS",
"first_name": "MARK",
"middle_name": "F",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-07",
"last_updated": "2010-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "MD00031603",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE L&I",
"identifier": "0126533",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE CRIME VICTIMS",
"identifier": "8928712",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE CRIME VICTIMS",
"identifier": "8937675",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE L&I",
"identifier": "0163664",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8154320",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "80138476",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in University Place, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.