Kelly Nicole Brothers, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

24921 Issued in SC

Practice address

445 King Street
Charleston, SC 29403

Phone

(843) 936-7174

Fax

(843) 881-5453

NPI assigned

Jun 2, 2021

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Mt Pleasant Dermatology

  • Dermatology Physician
  • Mount Pleasant, SC
  • NPI 1821048828
  NPD

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

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1679149470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 LONG POINT RD",
            "address_2": "STE 200",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294647940",
            "telephone_number": "843-881-0320",
            "fax_number": "843-881-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 KING STREET",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29403",
            "telephone_number": "843-936-7174",
            "fax_number": "843-881-5453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROTHERS",
        "first_name": "KELLY",
        "middle_name": "NICOLE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-02",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "24921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert C Brooks, O.D.
• Robert James Brooks, LMSW
• Stephanie Brooks, RN, NBC-HWC
• Thomas Andrew Brooks, DO
• Catelyn Brookshier, RD
• Thomas Brothers, MD
• Rachel Erin Brott, PA-C
• Kathleen Gay Broughan, PH.D.
• Lavonti Broughton
• Margaret Browder

• Family Nurse Practitioner in Charleston, SC
• Providers in Charleston, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.