Active NPI
Edwin Brooks
- Private Vehicle
- Columbus, OH
National Provider Identifier
1710425962
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Private Vehicle
- License
- DZK 7575
- Practice address
- 2155 Laurelwood Dr
Columbus, OH 43229-2812 - Phone
- (614) 895-1172
- NPI assigned
- Feb 8, 2017
- Last updated
- Feb 8, 2017
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Private Vehicle | 347C00000X | DZK 7575 | OH | Primary |
Addresses
Primary practice location
2155 Laurelwood Dr
Columbus, OH 43229-2812
Mailing address
2155 Laurelwood Dr
Columbus, OH 43229-2812
Phone (614) 895-1172
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0155889 | Medicaid | OH |
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 |
|---|---|---|---|
| DZK 7575 | OH | MD | Private Vehicle |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1486512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486512000000",
"number": "1710425962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2155 LAURELWOOD DR",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432292812",
"telephone_number": "614-895-1172"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2155 LAURELWOOD DR",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432292812",
"telephone_number": "614-895-1172"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOKS",
"first_name": "EDWIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-02-08",
"last_updated": "2017-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "347C00000X",
"taxonomy_group": "",
"desc": "Private Vehicle",
"state": "OH",
"license": "DZK 7575",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0155889",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.