Individual provider Active NPI

Brooke Laine

  • Medical Physician Assistant
  • Coral Springs, FL
National Provider Identifier
1811357064
Registry record updated Dec 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9109054 Issued in FL
Practice address
1500 N University Dr Ste 112
Coral Springs, FL 33071-6071
Phone
(954) 346-3120
NPI assigned
Mar 1, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9109054 FL Primary

Addresses

Primary practice location

1500 N University Dr Ste 112
Coral Springs, FL 33071-6071

Mailing address

4410 Sheridan St
Ste a
Hollywood, FL 33021-3553
Phone (609) 707-5898

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA9109054FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Zannis Family Medical Center Inc Past Accepting new patients

Organizations & group practices 1

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": "1456790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481241600000",
    "number": "1811357064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4410 SHERIDAN ST",
            "address_2": "STE A",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213553",
            "telephone_number": "609-707-5898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N UNIVERSITY DR STE 112",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330716071",
            "telephone_number": "954-346-3120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAINE",
        "first_name": "BROOKE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-01",
        "last_updated": "2016-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9109054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2016; 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.