Individual provider Active NPI

Brooke Johnson, APN

  • Family Nurse Practitioner
  • Clinton, IA
National Provider Identifier
1932531316
Registry record updated Jan 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A-122503 Issued in IA
Practice address
915 13TH Ave N
Clinton, IA 52732-5067
Phone
(563) 243-2511
Fax
(563) 243-7290
NPI assigned
Aug 7, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A-122503 IA Primary

Addresses

Primary practice location

915 13TH Ave N
Clinton, IA 52732-5067

Mailing address

500 W River Dr
Davenport, IA 52801-1014
Phone (563) 327-2035

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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

Enrollment IDStateProvider typePAC IDDetails
I20140424001634 IA Practitioner - Nurse Practitioner 9335375559 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Care IncGroup PAC ID 9830008895, 56 clinicians

Practice addresses (Care Compare)

500 W River Dr
Davenport, IA 52801-1014
Phone (563) 336-3000

925 S 4TH St
Clinton, IA 52732-5726
Phone (563) 336-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
A-122503IAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Care, Inc. Current Accepting new patients
Community Health Care, Inc. Current Accepting new patients
Community Health Care Inc CurrentSince Jul 11, 2016 Accepting new patients
Community Health Care Inc CurrentSince Jul 11, 2016 Accepting new patients

Locations

925 S 4th St
Clinton, IA 52732
Phone (563) 205-3578

500 W River Dr
Davenport, IA 52801
Phone (563) 327-2035

1510 E Rusholme St
Davenport, IA 52803
Phone (563) 359-6633

1221 Park Ave
Muscatine, IA 52761

312 Iowa Ave
Muscatine, IA 52761
Phone (563) 264-8506

2925 Cedar St
Ste 2
Muscatine, IA 52761
Phone (563) 263-7410

Interoperability endpoints

  • Direct secure messaging: bjohnson647913@direct.ochin.org

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1375833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484524800000",
    "number": "1932531316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W RIVER DR",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528011014",
            "telephone_number": "563-327-2035",
            "fax_number": "563-336-3014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 13TH AVE N",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527325067",
            "telephone_number": "563-243-2511",
            "fax_number": "563-243-7290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BROOKE",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-07",
        "last_updated": "2017-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A-122503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, IA

Sources for this page

Verify at the official NPI Registry.