Individual provider Active NPI

Jennifer Anne Brooks, M.D.

  • Family Medicine Physician
  • Golden Valley, MN
National Provider Identifier
1720068034
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
68191 Issued in MN
Practice address
8401 Golden Valley Rd
Golden Valley, MN 55427-4486
Phone
(952) 993-8300
Fax
(952) 993-8331
NPI assigned
Jan 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036128303 IL
Family Medicine Physician 207Q00000X 68191 MN Primary

Addresses

Primary practice location

8401 Golden Valley Rd
Golden Valley, MN 55427-4486

Mailing address

8401 Golden Valley Rd
Golden Valley, MN 55427-4486
Phone (952) 993-8300

Other practice location 1

633d Medical Group
77 Nealy Avenue
Joint Base Langley-Eustis, VA 23665-2040
Phone (757) 225-7630

Other names 1

  • Jennifer Anne Wright Former name

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036128303ILMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1720068034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8401 GOLDEN VALLEY RD",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554274486",
            "telephone_number": "952-993-8300",
            "fax_number": "952-993-8331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8401 GOLDEN VALLEY RD",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554274486",
            "telephone_number": "952-993-8300",
            "fax_number": "952-993-8331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "633d Medical Group",
            "address_2": "77 Nealy Avenue",
            "address_purpose": "LOCATION",
            "city": "Joint Base Langley-Eustis",
            "state": "VA",
            "postal_code": "236652040",
            "country_code": "US",
            "telephone_number": "757-225-7630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "JENNIFER",
        "middle_name": "ANNE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-20",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036128303",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "68191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "WRIGHT",
            "middle_name": "ANNE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Golden Valley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.