NPIMap

Organization Active NPI

Dr Jeffrey Brooks PC

  • Podiatrist
  • Jefferson City, MO
National Provider Identifier
1972069359
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
DR JEFFREY BROOKS PC
Doing business as
Dr Jeffrey Brooks PC
Practice address
221 Bolivar St
Jefferson City, MO 65101-1572
Phone
(248) 528-2116
NPI assigned
Feb 11, 2019
Last updated
Sep 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Authorized official

Name
Joy Stevens
Title
Credentialing Dept. Manager
Phone
(502) 244-2441

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

221 Bolivar St
Jefferson City, MO 65101-1572

Mailing address

12910 Shelbyville Rd Ste 300
Louisville, KY 40243-2404
Phone (502) 244-2441

Other names 1

  • Dr Jeffrey Brooks PC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190312000343 MO Part B Supplier - Clinic/Group Practice 6204175169 Receives reassigned benefits from 14 practitioners
Practice locations: Jefferson City, MO

National Provider Directory

National Provider Directory

Locations

618 N New Ballas Rd
Apt 40
Saint Louis, MO 63141

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1549843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727222400000",
    "number": "1972069359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12910 SHELBYVILLE RD STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402432404",
            "telephone_number": "502-244-2441",
            "fax_number": "502-996-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 BOLIVAR ST",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651011572",
            "telephone_number": "248-528-2116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR JEFFREY BROOKS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-11",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "JOY",
        "authorized_official_title_or_position": "CREDENTIALING DEPT. MANAGER",
        "authorized_official_telephone_number": "502-244-2441"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr Jeffrey Brooks PC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dr Jeffrey Brooks PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jefferson City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.