Robert R Broeckert, MS CCC-A

Primary specialty

AudiologistTaxonomy code 231H00000X

License

190-156 Issued in WI

Practice address

4650 W Spencer St
Suite 31
Appleton, WI 54914-9106

Phone

(920) 738-1819

NPI assigned

Jul 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hearing Clinics of Wisconsin, Inc

  • Audiologist-Hearing Aid Fitter
  • Appleton, WI
  • NPI 1164449831
  Medicare reassignment
• Hearing Clinics of Wisconsin, LLC

  • Audiologist
  • Appleton, WI
  • NPI 1497543730
  NPD (past)

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1750308649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 S CLARA ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549154061",
            "telephone_number": "920-213-0767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 W SPENCER ST",
            "address_2": "SUITE 31",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549149106",
            "telephone_number": "920-738-1819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROECKERT",
        "first_name": "ROBERT",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "MS CCC-A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-16",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "WI",
            "license": "190-156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41128800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Brochtrup
• Samuel Brock
• Kristen Jeanne Brockdorf, PA-C
• Paige Brockdorf, DNP, APRN, FNP-BC
• Rebecca M Broeckert, M.D.
• Mackenzie Broeren, APRN, PMHNP-BC
• Dakota Brooker
• Christina Brooks, M.D.
• Sarah Brosman, PMHNP
• Brotherly Love, LLC

• Audiologist in Appleton, WI
• Providers in Appleton, WI by specialty
• Audiologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.