Bobby Joe Brooks, MD
Individual provider Active NPI Family Medicine Physician · Campbellsville, KY
NPI 1689670671 · NPPES record last updated Jul 21, 2010
Key facts
- NPI
- 1689670671
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 17421 (KY)
- Practice address
- 127 Kingswood Dr
Campbellsville, KY 42718-9634 - Phone
- (270) 789-3410
- Fax
- (270) 465-2449
- NPI assigned
- Jun 23, 2005
- Reactivated
- Mar 22, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 92.9 of 100
- Quality
- 85.93
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100922000654 | KY | Practitioner - General Practice |
5597678938 | Practice locations: Prospect, KY |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17421 | KY | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Cardiology Associates PLLC | Past | Accepting new patients | |
| Genesis Enterprises, Inc. | Family Medicine | Past | Accepting new patients |
| Bobby J. Brooks, M.D. | Family Medicine | Past |
Accepting new patients |
| Bobby J. Brooks, M.D. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 17421 | KY | Yes |
Addresses
Primary practice location
127 Kingswood Dr
Campbellsville, KY 42718-9634
Mailing address
127 Kingswood Dr
Campbellsville, KY 42718-9634
Phone (270) 789-3410
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64174212 | Medicaid | KY |
Other providers in Campbellsville, KY
- Kristen Marie Brents
- Michael Clelland Brents
- Amanda Diane Bright
- Brightview LLC
- Broken to Blessed Recovery Inc
- Shayla Brown
- Jessica Nicole Browning
- Barbara Sue Bryant
- Debra Bradshaw Buckman
- Sarah Elaine Buckman
All providers in Campbellsville, KY · Family Medicine Physician in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.