Individual provider Active NPI

Brooke M Collins

  • Specialist
  • Minot, ND
National Provider Identifier
1760134100
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
1015 S Broadway Ste 18
Minot, ND 58701-4667
Phone
(701) 857-8500
Fax
(701) 857-8555
NPI assigned
Jan 26, 2022
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary
Case Manager/Care Coordinator 171M00000X

Addresses

NPPES NPI Registry

Primary practice location

1015 S Broadway Ste 18
Minot, ND 58701-4667

Mailing address

1015 S Broadway Ste 18
Minot, ND 58701-4667
Phone (701) 857-8500

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 16, 2024.

{
    "created_epoch": "1643155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1760134100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 S BROADWAY STE 18",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587014667",
            "telephone_number": "701-857-8500",
            "fax_number": "701-857-8555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 S BROADWAY STE 18",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587014667",
            "telephone_number": "701-857-8500",
            "fax_number": "701-857-8555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "BROOKE",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-26",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minot, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2024; 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.