Nancy Brockington, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G69128 Issued in CA

Practice address

38883 Hwy 299
Willow Creek, CA 95573

Phone

(530) 629-3111

NPI assigned

Feb 8, 2007

Last updated

Apr 19, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

University of California, Davis School of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Open Door Community Health CentersGroup PAC ID 9436067485, 113 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nbrockington12175@direct.ochin.org

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.

• Open Door Community Health Centers

  dba Del Norte Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Crescent City, CA
  • NPI 1497840656
  Medicare reassignment Care Compare group NPD
• Open Door Community Health Centers

  dba Humboldt Open Door Clinic

  • Federally Qualified Health Center (FQHC)
  • Arcata, CA
  • NPI 1255435533
  NPD
• Open Door Community Health Centers

  dba Fortuna Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Fortuna, CA
  • NPI 1306252051
  NPD
• Open Door Community Health Centers

  dba Willow Creek Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Willow Creek, CA
  • NPI 1730330739
  NPD
• Open Door Community Health Centers

  dba Open Door Downtown

  • Federally Qualified Health Center (FQHC)
  • Eureka, CA
  • NPI 1831713452
  NPD

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555632000000",
    "number": "1629119334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 9TH ST",
            "address_2": "SUITE 203",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955216248",
            "telephone_number": "707-826-8633",
            "fax_number": "707-826-8638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38883 HWY 299",
            "city": "WILLOW CREEK",
            "state": "CA",
            "postal_code": "95573",
            "telephone_number": "530-629-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKINGTON",
        "first_name": "NANCY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2019-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G69128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Norman Bensky, M.D.
• Brian Bottemiller, RPH
• Lanesha Bracy, NP
• Aileen Burns, RN
• Lamont Damon
• Jerome Michael Decapua, D.C.
• Laura Denight, RN
• Lexi M Doolittle

• Family Medicine Physician in Willow Creek, CA
• Providers in Willow Creek, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.