Individual provider Active NPI

Lynsey Brouillette, DNP ARNP

  • Family Medicine Physician
  • Mapleton, IA
National Provider Identifier
1770328528
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A179930 Issued in IA
Practice address
513 S Muckey St
Mapleton, IA 51034-1055
Phone
(712) 882-2234
NPI assigned
Jun 25, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A179930 IA Primary

Addresses

Primary practice location

513 S Muckey St
Mapleton, IA 51034-1055

Mailing address

803 Main St
Mapleton, IA 51034-1325
Phone (712) 880-2666

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
I20240826002188 IA Practitioner - Nurse Practitioner 0648719302 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A179930IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Burgess Health Center Family Medicine CurrentSince Jul 8, 2024 Accepting new patients
Burgess Health Center CurrentSince Jul 8, 2024 Accepting new patients
Burgess Health Center Current Accepting new patients
Burgess Health Center Family Medicine Past Accepting new patients

Locations

513 S Muckey St
Mapleton, IA 51034
Phone (712) 880-0222

1600 Diamond St
Onawa, IA 51040
Phone (712) 423-2311

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1719273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1770328528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 MAIN ST",
            "city": "MAPLETON",
            "state": "IA",
            "postal_code": "510341325",
            "telephone_number": "712-880-2666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 S MUCKEY ST",
            "city": "MAPLETON",
            "state": "IA",
            "postal_code": "510341055",
            "telephone_number": "712-882-2234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUILLETTE",
        "first_name": "LYNSEY",
        "credential": "DNP ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-25",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "A179930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mapleton, IA

Sources for this page

Verify at the official NPI Registry.