Clyde L Brooks, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

32224 Issued in NC

Practice address

521 Moye Blvd
Ecu Physicians
Greenville, NC 27834-4300

Phone

(252) 744-3229

Fax

(252) 744-3924

NPI assigned

Jul 1, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Healthaccess, Inc

  • Home Health Agency
  • Kenansville, NC
  • NPI 1134599137
  NPD (past)

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

{
    "created_epoch": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231459200000",
    "number": "1912904129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 751069",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751069",
            "telephone_number": "252-744-3258",
            "fax_number": "252-744-3194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 MOYE BLVD",
            "address_2": "ECU PHYSICIANS",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278344300",
            "telephone_number": "252-744-3229",
            "fax_number": "252-744-3924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "CLYDE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-01",
        "last_updated": "2009-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "32224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8911605",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110176310",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "11605",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allison Brodeur, LMFT
• Brian N Brodish, MD
• Michael A Brone, DC
• Brookdale Senior Living Communities, Inc.
• Angela Brooks, PA-C
• Rebecca Brooks
• Kathryn K Brophy
• Mateusz Broszko, M.D.
• Samantha Karlene Brown Cunningham, PHD
• Amy Sue Brown Price

• All providers in Greenville, NC
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.