James T Brocksmith, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

DOR3M91 Issued in MO

Practice address

1705 E Broadway
Suite 220
Columbia, MO 65201-7166

Phone

(573) 875-6504

Fax

(573) 875-7168

NPI assigned

Apr 7, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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.

• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346803200000",
    "number": "1922061373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 E BROADWAY",
            "address_2": "SUITE 220",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652017166",
            "telephone_number": "573-875-6504",
            "fax_number": "573-875-7168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 E BROADWAY",
            "address_2": "SUITE 220",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652017166",
            "telephone_number": "573-875-6504",
            "fax_number": "573-875-7168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKSMITH",
        "first_name": "JAMES",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-07",
        "last_updated": "2012-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "DOR3M91",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "242839900",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Broadway Urgent Care LLC
• Devara Brock-Stevens
• John J. Brockland, MD
• Elisabeth Louise Brockman-Knight, MA, LPC
• Tina Brockman, MD
• Tia Yaa Asantewa Brodeur, MD
• Katherine R Broeder, CRNA
• Ann Marie Bromstedt, R.PH.
• Angela Justine Brooks, LMSW
• Blake Jay Brooks, M.D.

• Internal Medicine Physician in Columbia, MO
• Providers in Columbia, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2012; 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.