NPIMap

Organization Active NPI

Ole Brook Kids, P.C.

Doing business as Ole Brook Kids Wellness and Urgent Care

  • Pediatric Nurse Practitioner
  • Brookhaven, MS
National Provider Identifier
1649051046
Registry record updated Jan 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
Legal business name
OLE BROOK KIDS, P.C.
Doing business as
Ole Brook Kids Wellness and Urgent Care
Practice address
508 Brookway Blvd
Brookhaven, MS 39601-3267
Phone
(601) 835-1062
NPI assigned
Oct 11, 2023
Last updated
Jan 25, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2026

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

Authorized official

Name
Mrs. Amber Nicole Martin, APRN, CPNPNPI 1194064188
Title
Owner/Nurse Practitioner
Phone
(601) 757-9689

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0200X Primary

Addresses

Primary practice location

508 Brookway Blvd
Brookhaven, MS 39601-3267

Mailing address

PO Box 1403
Brookhaven, MS 39602-1403
Phone (601) 757-9689

Other practice location 1

301C Highway 51 S
Brookhaven, MS 39601-3247
Phone (601) 835-1062

Other names 1

  • Ole Brook Kids Wellness and Urgent Care Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D2293540Ole Brook Kids PC508 Brookway Blvd, Brookhaven, MS 39601Certificate of waiverNov 8, 2027

National Provider Directory

National Provider Directory

Locations

301C Highway 51 S
Brookhaven, MS 39601
Phone (601) 833-7261

508 Brookway Blvd
Brookhaven, MS 39601
Phone (601) 835-1062

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1696982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769299200000",
    "number": "1649051046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1403",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396021403",
            "telephone_number": "601-757-9689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 BROOKWAY BLVD",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396013267",
            "telephone_number": "601-835-1062"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301C Highway 51 S",
            "address_purpose": "LOCATION",
            "city": "Brookhaven",
            "state": "MS",
            "postal_code": "396013247",
            "country_code": "US",
            "telephone_number": "601-835-1062",
            "fax_number": "601-835-9233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OLE BROOK KIDS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-11",
        "last_updated": "2026-01-25",
        "certification_date": "2026-01-25",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "AMBER",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER/NURSE PRACTITIONER",
        "authorized_official_telephone_number": "601-757-9689",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APRN, CPNP"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ole Brook Kids Wellness and Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brookhaven, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.