Brooke Diane Mingenback, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA04987 Issued in TX

Practice address

800 Orthopedic Way
Arlington, TX 76015-1629

Phone

(817) 375-5200

Fax

(817) 299-1731

NPI assigned

Sep 21, 2006

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

Other names 1

• Brooke Diane Gates Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Orthotx, PLLC

  • Orthopaedic Surgery Physician
  • Arlington, TX
  • NPI 1336134469
  NPD (past)

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221004800000",
    "number": "1790884534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 120489",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760120489",
            "telephone_number": "817-375-5200",
            "fax_number": "817-299-1731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 ORTHOPEDIC WAY",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760151629",
            "telephone_number": "817-375-5200",
            "fax_number": "817-299-1731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINGENBACK",
        "first_name": "BROOKE",
        "middle_name": "DIANE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2008-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BROOKE",
            "last_name": "GATES",
            "middle_name": "DIANE",
            "credential": "PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mind & Wellness Behavioral Health LLC
• Mind & Wellness Health Services, Dba
• Mind Above Matter LLC
• Mindful Community Living, Inc.
• Mindful Community Living, Inc.
• Minh Michael Huynh, DC
• Minimally Invasive Bariatrics
• Vaneza Judith Minniear
• Janece Marie Minnieweather
• Latoya S Minor, LCSW

• Physician Assistant in Arlington, TX
• Providers in Arlington, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2008; 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.