Active NPI
Brooke Elaine Dabbert, FNP-C
- Family Nurse Practitioner
- Goshen, IN
National Provider Identifier
1831443555
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 71004324A
- Practice address
- 200 High Park Ave
Goshen, IN 46526-4810 - Phone
- (574) 364-2888
- Fax
- (574) 364-2890
- NPI assigned
- Nov 2, 2012
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 71004324A | IN | Primary |
Addresses
Primary practice location
200 High Park Ave
Goshen, IN 46526-4810
Mailing address
200 High Park Ave
Goshen, IN 46526-4810
Phone (574) 364-2888
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201134390 | Medicaid | IN |
Other names 1
- Brooke Elaine Martin
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | bdabbert@goshenhealth.direct.varian.com | Health Information Exchange (HIE) |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 71004324A | IN | MD | Family Nurse Practitioner |
Interoperability endpoints
- bdabbert@goshenhealth.direct.varian.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1351814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611100800000",
"number": "1831443555",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 HIGH PARK AVE",
"city": "GOSHEN",
"state": "IN",
"postal_code": "465264810",
"telephone_number": "574-364-2888",
"fax_number": "574-364-2890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 HIGH PARK AVE",
"city": "GOSHEN",
"state": "IN",
"postal_code": "465264810",
"telephone_number": "574-364-2888",
"fax_number": "574-364-2890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DABBERT",
"first_name": "BROOKE",
"middle_name": "ELAINE",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-11-02",
"last_updated": "2021-01-20",
"certification_date": "2021-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IN",
"license": "71004324A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201134390",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "bdabbert@goshenhealth.direct.varian.com",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "200 High Park Ave",
"city": "Goshen",
"state": "IN",
"country_code": "US",
"postal_code": "465264810",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "BROOKE",
"last_name": "MARTIN",
"middle_name": "ELAINE",
"credential": "FNP-C",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Goshen, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.