Individual provider Active NPI

Brooke A Scholler

  • Psychiatric/Mental Health Nurse Practitioner
  • West Allis, WI
National Provider Identifier
1912343591
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
13043-33 Issued in WI
Practice address
11101 W Lincoln Ave
West Allis, WI 53227-1133
Phone
(262) 646-4411
Fax
(414) 797-0804
NPI assigned
May 22, 2013
Last updated
Aug 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 13043-33 WI Primary

Addresses

Primary practice location

11101 W Lincoln Ave
West Allis, WI 53227-1133

Mailing address

600 W Virginia St
Suite 203
Milwaukee, WI 53204-1500
Phone (414) 831-4500

Other practice location 1

600 W Virginia St
Suite 203
Milwaukee, WI 53204-1500
Phone (414) 831-4500

Other identifiers 1

IdentifierTypeStateIssuer
16902-130OtherWIWISCONSIN DEPARTMENT OF SAFETY AND PROFESSIONAL SERVICES

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
13043-33WIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Bridge Health Clinics & Research Centers, Inc. PastSince May 1, 2012 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1369180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1912343591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 W VIRGINIA ST",
            "address_2": "SUITE 203",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532041500",
            "telephone_number": "414-831-4500",
            "fax_number": "414-255-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11101 W LINCOLN AVE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532271133",
            "telephone_number": "262-646-4411",
            "fax_number": "414-797-0804"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 W Virginia St",
            "address_2": "Suite 203",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532041500",
            "country_code": "US",
            "telephone_number": "414-831-4500",
            "fax_number": "414-255-3451",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHOLLER",
        "first_name": "BROOKE",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-22",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "13043-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WISCONSIN DEPARTMENT OF SAFETY AND PROFESSIONAL SERVICES",
            "identifier": "16902-130",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Allis, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2022; 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.