Active NPI
Kenneth P Brooks, M.D.
- Psychiatry Physician
- Richmond, VA
National Provider Identifier
1821088444
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 0101030760
- Practice address
- 1000 Boulders Pkwy
Suite 202
Richmond, VA 23225 - Phone
- (804) 320-7881
- Fax
- (804) 560-3474
- NPI assigned
- Oct 25, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 0101030760 | VA | Primary |
Addresses
Primary practice location
1000 Boulders Pkwy
Suite 202
Richmond, VA 23225
Mailing address
1000 Boulders Pkwy
Suite 202
Richmond, VA 23225
Phone (804) 320-7881
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 007181990 | Medicaid | VA |
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
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tucker Psychiatric Clinic Inc. | Psychiatry | 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": "1130198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266969600000",
"number": "1821088444",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 BOULDERS PKWY",
"address_2": "SUITE 202",
"city": "RICHMOND",
"state": "VA",
"postal_code": "23225",
"telephone_number": "804-320-7881",
"fax_number": "804-560-3474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 BOULDERS PKWY",
"address_2": "SUITE 202",
"city": "RICHMOND",
"state": "VA",
"postal_code": "23225",
"telephone_number": "804-320-7881",
"fax_number": "804-560-3474"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOKS",
"first_name": "KENNETH",
"middle_name": "P",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-25",
"last_updated": "2010-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "VA",
"license": "0101030760",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "007181990",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Richmond, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.