Nolan R. Brooksby, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

5611703-1204 Issued in UT

Practice address

151 W 200 N
Vernal, UT 84078-1907

Phone

(435) 789-3342

NPI assigned

Jun 10, 2006

Last updated

Apr 15, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hospitalist Medicine Physicians of Utah -TCG LLCGroup PAC ID 7719366186, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ashley Regional Medical Center Hospital, Vernal, UT, CCN 460030

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Hospitalist Medicine Physicians of Utah -TCG LLC

  • Emergency Medicine Physician
  • Vernal, UT
  • NPI 1093294563
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ashley Valley Medical Center LLC

  dba Ashley Regional Medical Center

  • General Acute Care Hospital
  • Vernal, UT
  • NPI 1447296249
  Care Compare affiliation

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271289600000",
    "number": "1912949603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 W 100 N",
            "city": "VERNAL",
            "state": "UT",
            "postal_code": "840782036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 W 200 N",
            "city": "VERNAL",
            "state": "UT",
            "postal_code": "840781907",
            "telephone_number": "435-789-3342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKSBY",
        "first_name": "NOLAN",
        "middle_name": "R.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2010-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "UT",
            "license": "5611703-1204",
            "primary": true
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "UT",
            "license": "55611703-1204",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "56117031200001",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D5681",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00187532",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian W Spendlove DDS PC
• Jessica Briggs, LCSW
• Bright Minds Developmental Center, LLC
• Nathan Ryan Britt, BCBA, LBA-UT
• Mark Christian Brixey, D.C.
• Stephanie Kay Brown
• Joyce F Buhler, RD CD CDE
• Edwin Bulloch, CRNA
• Haden Bunderson
• Burk T Young MD PC

• Emergency Medicine Physician in Vernal, UT
• Providers in Vernal, UT by specialty
• Emergency Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2010; 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.