Individual provider Active NPI

Brooks Forsythe Schomp, PA-C

  • Physician Assistant
  • Kenansville, NC
National Provider Identifier
1639688906
Registry record updated Sep 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-07605 Issued in NC
Practice address
401 N Main St
Kenansville, NC 28349-8801
Phone
(910) 296-0942
NPI assigned
Sep 29, 2017
Last updated
Sep 29, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-07605 NC Primary

Addresses

Primary practice location

401 N Main St
Kenansville, NC 28349-8801

Mailing address

6313 Hawks Bill Dr
Wilmington, NC 28409-9281

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20171212000513 NC Practitioner - Physician Assistant 6901164474 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.95 of 100Reported as apm
Quality
82.44
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-07605NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vidant Medical Group LLC CurrentSince Oct 10, 2017 Accepting new patients

Locations

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

Organizations & group practices 1

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": "1506643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506643200000",
    "number": "1639688906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6313 HAWKS BILL DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284099281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N MAIN ST",
            "city": "KENANSVILLE",
            "state": "NC",
            "postal_code": "283498801",
            "telephone_number": "910-296-0942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOMP",
        "first_name": "BROOKS",
        "middle_name": "FORSYTHE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-29",
        "last_updated": "2017-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-07605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenansville, NC

Sources for this page

Verify at the official NPI Registry.