Active NPI
Johanna M Brooks, PA-C
- Medical Physician Assistant
- Surprise, AZ
National Provider Identifier
1700835642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 3785
- Practice address
- 14239 West Bell Road
Suite 112
Surprise, AZ 85374-2469 - Phone
- (623) 876-9983
- Fax
- (623) 876-9984
- NPI assigned
- May 8, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 3785 | AZ | Primary |
Addresses
Primary practice location
14239 West Bell Road
Suite 112
Surprise, AZ 85374-2469
Mailing address
14239 West Bell Road
Suite 112
Surprise, AZ 85374-2469
Phone (623) 876-9983
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3785 | Other | AZ | ARIZONA REGULATORY BOARD OF PHYSICIAN ASSISTANTS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3785 | AZ | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414454400000",
"number": "1700835642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14239 WEST BELL ROAD",
"address_2": "SUITE 112",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853742469",
"telephone_number": "623-876-9983",
"fax_number": "623-876-9984"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14239 WEST BELL ROAD",
"address_2": "SUITE 112",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853742469",
"telephone_number": "623-876-9983",
"fax_number": "623-876-9984"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOKS",
"first_name": "JOHANNA",
"middle_name": "M",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-08",
"last_updated": "2014-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "AZ",
"license": "3785",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARIZONA REGULATORY BOARD OF PHYSICIAN ASSISTANTS",
"identifier": "3785",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Surprise, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.