Kimberly Crockett Brasure, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

LG0001010 Issued in DE

Practice address

35998 Zion Church Rd Unit 1
Frankford, DE 19945-4501

Phone

(302) 278-0093

Fax

(302) 278-0096

NPI assigned

Feb 1, 2017

Last updated

Sep 30, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2025 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Wellness by the Sea LLC

  • Nurse Practitioner
  • Frankford, DE
  • NPI 1972012367
  Authorized official Same address or phone
• Wellness by the Sea Med Spa LLC

  • Nurse Practitioner
  • Frankford, DE
  • NPI 1295448686
  NPD

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

{
    "created_epoch": "1485907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1942748736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31707 BRASURE RD",
            "city": "DAGSBORO",
            "state": "DE",
            "postal_code": "199394172",
            "telephone_number": "302-278-0093",
            "fax_number": "302-278-0096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35998 ZION CHURCH RD UNIT 1",
            "city": "FRANKFORD",
            "state": "DE",
            "postal_code": "199454501",
            "telephone_number": "302-278-0093",
            "fax_number": "302-278-0096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRASURE",
        "first_name": "KIMBERLY",
        "middle_name": "CROCKETT",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-01",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DE",
            "license": "LG0001010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blanche Aaron, RN
• Karen A Abato, LPC
• Amanda Backof
• Micaela Boyer, BSN, RN
• Chuck Cris Coleman
• Connections CSP, Inc. (Roxanna Group Home)
• Beverly Elaine Cox, MA, CCC-SLP
• Thomas J Craney, PH.D.
• Delmarva Surgical

• Nurse Practitioner in Frankford, DE
• Providers in Frankford, DE by specialty
• Nurse Practitioner in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.