Hailey Brockman, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

207596 Issued in GA

Practice address

1120 15TH St
Ba - 4236
Augusta, GA 30912-0004

Phone

(706) 627-0767

NPI assigned

Jul 13, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Merit-based Incentive Payment System (MIPS)

Final score

93.93 of 100Reported as apm

Quality

82.14

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Au Medical Associates Inc

  • Multi-Specialty Clinic/Center
  • Augusta, GA
  • NPI 1841230620
  Medicare reassignment NPD
• Au Medical Associates Inc

  • Durable Medical Equipment & Medical Supplies
  • Augusta, GA
  • NPI 1114574126
  NPD
• Department of Behavioral Health and Developmental Disabilities

  • Intellectual Disabilities Intermediate Care Facility
  • Gracewood, GA
  • NPI 1699000703
  NPD (past)

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

{
    "created_epoch": "1436745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436745600000",
    "number": "1770967440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 15TH ST",
            "address_2": "BA - 4236",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120004",
            "telephone_number": "706-627-0767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 15TH ST",
            "address_2": "BA - 4236",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120004",
            "telephone_number": "706-627-0767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKMAN",
        "first_name": "HAILEY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-13",
        "last_updated": "2015-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "207596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eduardo E Britton, DDS
• Bryan Richard Broach, M.D.
• Gary Broadnax, MD
• Kelli Nicole Broadus, FNP-C
• Joseph Clayton Brock Jr., DO
• Jennifer Brodil, OD
• Marc Daniel Brody, PT
• Natalia Brody, MD
• Margaret Brogan
• Richard Harris Bromer, M.D.

• Family Nurse Practitioner in Augusta, GA
• Providers in Augusta, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.