NPIMap

Individual provider Active NPI

Molly Maggard Brockman, M.D.

  • Internal Medicine Physician
  • Shepherdsville, KY
National Provider Identifier
1932594736
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
52490 Issued in KY
Practice address
115 Huston Dr Ste 1
Shepherdsville, KY 40165-7250
Phone
(502) 955-7311
Fax
(502) 891-8338
NPI assigned
Mar 30, 2015
Last updated
Feb 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 52490 KY
Internal Medicine Physician 207R00000X 52490 KY Primary

Addresses

Primary practice location

115 Huston Dr Ste 1
Shepherdsville, KY 40165-7250

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 272-5196

Other identifiers 3

IdentifierTypeStateIssuer
K310660OtherKYMEDICARE
52490OtherKYMEDICAL LICENSE
7100430860MedicaidKY

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://epicsoap.nortonhealthcare.org/FHIRPRD/api/FHIR/DSTU2/
Direct Messaging Address mbrockman85154@direct.nortonhealthcare.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191205002708 KY Practitioner - Internal MedicinePractitioner - Pediatric Medicine 8921314204 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
University of Louisville School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians

Practice addresses (Care Compare)

115 Huston Dr
Shepherdsville, KY 40165-7250
Phone (502) 957-6434

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.11 of 100Reported as group
Quality
63.34
Promoting interoperability
100
Improvement activities
40
Cost
73.68

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
52490KYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. Current Accepting new patients
Community Medical Associates, Inc. Internal Medicine CurrentSince Nov 1, 2019 Accepting new patients
Community Medical Associates, Inc. Internal Medicine CurrentSince Nov 1, 2019 Accepting new patients

Locations

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

115 Huston Dr
Shepherdsville, KY 40165
Phone (502) 365-2655

115 Huston Dr
Ste 1
Shepherdsville, KY 40165
Phone (502) 955-7311

Interoperability endpoints

  • Direct secure messaging: mbrockman85154@direct.nortonhealthcare.org

Organizations & group practices 3

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.

Hospital & facility affiliations 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1932594736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-272-5196",
            "fax_number": "502-272-5339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 HUSTON DR STE 1",
            "city": "SHEPHERDSVILLE",
            "state": "KY",
            "postal_code": "401657250",
            "telephone_number": "502-955-7311",
            "fax_number": "502-891-8338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKMAN",
        "first_name": "MOLLY",
        "middle_name": "MAGGARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-30",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "52490",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "52490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "K310660",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "52490",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100430860",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicsoap.nortonhealthcare.org/FHIRPRD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "115 Huston Dr Ste 1",
            "city": "Shepherdsville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "401657250",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbrockman85154@direct.nortonhealthcare.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "115 Huston Dr Ste 1",
            "city": "Shepherdsville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "401657250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Shepherdsville, KY

Sources for this page

Verify at the official NPI Registry.