Camille Tisha Brockett, NP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

RN184254NP Issued in GA

Practice address

Emory University Hospital Emergency Department
1364 Cliffton Road
Atlanta, GA 30322-1006

Phone

(404) 712-2000

NPI assigned

Apr 10, 2008

Last updated

Dec 12, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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

Specialty

Nurse Practitioner

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Grady Memorial Hospital CorporationGroup PAC ID 7517032998, 365 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

96.48 of 100Reported as group

Quality

87.56

Promoting interoperability

100

Improvement activities

40

Cost

75.14

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: camille.brockett.1@24481.direct.athenahealth.com
• Direct secure messaging: camille.brockett.1@31578.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grady Memorial Hospital Corporation

  dba Grady Health System

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1114243813
  Medicare reassignment Care Compare group NPD
• The Emory Clinic Inc

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1396798229
  Medicare reassignment Care Compare group NPD
• Grady Memorial Hospital Corporation

  dba Grady Inpatient Rehabilitation Unit

  • Rehabilitation Hospital
  • Atlanta, GA
  • NPI 1336961119
  NPD
• Grady Memorial Hospital Corporation

  dba Grady Health Systems

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1992799050
  NPD (past)

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1902079957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2224 AUSTIN LAKE DR SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300823380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EMORY UNIVERSITY HOSPITAL EMERGENCY DEPARTMENT",
            "address_2": "1364 CLIFFTON ROAD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221006",
            "telephone_number": "404-712-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKETT",
        "first_name": "CAMILLE",
        "middle_name": "TISHA",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-10",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN184254",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN184254NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Regina Brock-Huff, OTR
• Kaitlyn Brock, CPNP
• Katharine Elizabeth Brock, M.D., M.S.
• La-Urshalar B Brock, CNM, FNP-BC
• Sheila Elizabeth Brock, OTRL
• Christopher Brockett Jr.
• Paul William Brocklebank II
• Laura Brockmann
• Caroline Brockmeier
• Kari Broder, DO

• Acute Care Nurse Practitioner in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Acute Care Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; 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.