Individual provider Active NPI

Brooke Anne Bradley, ARNP

  • Nurse Practitioner
  • Muscatine, IA
National Provider Identifier
1710167895
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
A110099 Issued in IA
Practice address
2104 Cedarwood Dr Lowr Level
Muscatine, IA 52761-2669
Phone
(319) 688-7921
Fax
(319) 688-7776
NPI assigned
Nov 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X A110099 IA Primary

Addresses

Primary practice location

2104 Cedarwood Dr Lowr Level
Muscatine, IA 52761-2669

Mailing address

2104 Cedarwood Dr Lowr Level
Muscatine, IA 52761-2669
Phone (319) 688-7921

Other identifiers 1

IdentifierTypeStateIssuer
1710167895MedicaidIA

Other names 1

  • Brooke Anne McCuen Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071207000154 IA Practitioner - Nurse Practitioner 1254420748 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ENT Medical Services PCGroup PAC ID 7113819863, 8 clinicians
Advanced Physical Therapy Services, LTD.Group PAC ID 9133101462, shared by 5 NPIs, 216 clinicians

Practice addresses (Care Compare)

2615 Northgate Dr
Iowa City, IA 52245-9502
Phone (319) 351-5680

300 Tenney St
Kewanee, IL 61443-3452
Phone (309) 853-5500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
A110099IAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
ENT Medical Services PC CurrentSince Oct 1, 2021 Accepting new patients
Trinity Regional Medical Center Past Accepting new patients
ENT Medical Services Hearing Aid Services Past Accepting new patients

Locations

2615 Northgate Dr
Iowa City, IA 52245
Phone (319) 337-6879

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1194307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1710167895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2104 CEDARWOOD DR LOWR LEVEL",
            "city": "MUSCATINE",
            "state": "IA",
            "postal_code": "527612669",
            "telephone_number": "319-688-7921",
            "fax_number": "319-688-7776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2104 CEDARWOOD DR LOWR LEVEL",
            "city": "MUSCATINE",
            "state": "IA",
            "postal_code": "527612669",
            "telephone_number": "319-688-7921",
            "fax_number": "319-688-7776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "BROOKE",
        "middle_name": "ANNE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-06",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "A110099",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710167895",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BROOKE",
            "last_name": "MCCUEN",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Muscatine, IA

Sources for this page

Verify at the official NPI Registry.