Active NPI
Shannon Lynn Brooks, APRN
- Family Nurse Practitioner
- Louisville, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 3014491
- Practice address
- 170 Dr Arla Way Ste 101
Louisville, KY 40229-5427 - Phone
- (502) 955-8480
- NPI assigned
- Jul 20, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | KY19765 | KY | |
| Family Nurse Practitioner | 363LF0000X | APRN.CNP.0042420 | OH | |
| Family Nurse Practitioner | 363LF0000X | 3014491 | KY | Primary |
Addresses
Primary practice location
170 Dr Arla Way Ste 101
Louisville, KY 40229-5427
Mailing address
314 Braeburn Dr
Brooks, KY 40109-5074
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI, TX, KY, MA, CA, CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 6
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
200 Oceangate
Suite 100
Long Beach, CA 90802-4316
200 Oceangate
Suite 100
Long Beach, CA 90802-4317
314 Braeburn Dr
Brooks, KY 40109-5074
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| KY19765 | KY | MD | Family Medicine Physician |
| 3014491 | KY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Molina Care Connections, LLC. | Current | Accepting new patients | |
| Central Health Plan of California, Inc. | Current | Accepting new patients | |
| Molina Healthcare of California | Current | Accepting new patients |
Locations
200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666
175 Scott Swamp Rd
Farmington, CT 06032
Phone (860) 249-6752
5100 Commerce Crossings Dr
Louisville, KY 40229
Phone (502) 305-6267
1075 Main St
Fl 4
Waltham, MA 02451
880 W Long Lake Rd
Troy, MI 48098
Phone (248) 227-6316
3000 Corporate Exchange Dr
Columbus, OH 43231
Phone (614) 942-3042
5605 N MacArthur Blvd
Ste 400
Irving, TX 75038
Phone (972) 536-7265
1660 Westridge Cir N
Irving, TX 75038
Phone (214) 467-9787
Interoperability endpoints
- sbrooks12259@direct-prd.molinahealthcare.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 and National Provider Directory roles.
-
- Health Maintenance Organization
- Diamond Bar, CA
- NPI 1386714772
-
dba Molina CC
- Nurse Practitioner
- Long Beach, CA
- NPI 1407243223
CT, KY, MA, MI, TX
-
dba Molina Medical Centers
- Health Maintenance Organization
- Long Beach, CA
- NPI 1194811760
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783468800000",
"number": "1639787245",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "314 BRAEBURN DR",
"city": "BROOKS",
"state": "KY",
"postal_code": "401095074"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "170 DR ARLA WAY STE 101",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402295427",
"telephone_number": "502-955-8480"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOKS",
"first_name": "SHANNON",
"middle_name": "LYNN",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-20",
"last_updated": "2026-07-08",
"certification_date": "2026-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "KY",
"license": "KY19765",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OH",
"license": "APRN.CNP.0042420",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "KY",
"license": "3014491",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2026; 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.