BROOKE BOGGS LLC (NPI# 1396300562) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396300562 |
| Entity Type | Organization |
| Organization Name | BROOKE BOGGS LLC |
| Practice Address |
1917 W Faidley Ave Grand Island NE 68803-4642 |
| Practice Telephone | 3083980350 |
| Practice Fax Number | 3083980351 |
| Mailing Telephone | 3083980350 |
| Mailing Fax Number | 3083980351 |
| Enumeration Date | 2019-05-03 |
| Last Update Date | 2019-05-03 |
| Authorized Official Name | BROOKE NICOLE BOGGS (OWNER/PROVIDER) |
| Authorized Official Telephone | 3085306569 |
| Authorized Official Credential | APRN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NE | 50511752800 | 05 |
| Street Address |
1917 W FAIDLEY AVE |
| City | GRAND ISLAND |
| State | NE |
| Zip Code | 68803-4642 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811131840 | Ryan Christopher Ernst | Clinical Neuropsychologist | 1917 W Faidley Ave, Grand Island, NE 68803 | 2009-04-21 |
| 1588265615 | Celianne Marie Bacon | Nurse Practitioner | 1917 W Faidley Ave, Grand Island, NE 68803-4642 | 2020-11-04 |
| 1518517432 | Dave Hoyt Counseling, LLC | Counselor | 1917 W Faidley Ave, Grand Island, NE 68803-4642 | 2019-09-12 |
| 1699327098 | Deborah Grace Thimsen-villa Dba Verigratia Counseling | Counselor | 1917 W Faidley Ave, Grand Island, NE 68803-4642 | 2019-07-15 |
| 1265098172 | Neuro Health, PC | Clinical Neuropsychologist | 1917 W Faidley Ave, Grand Island, NE 68803-4642 | 2019-05-15 |
| 1598283558 | Amandarose Dubas | Social Worker | 1917 W Faidley Ave, Grand Island, NE 68803-4642 | 2017-08-30 |
| 1801314869 | Amanda Dubas, LLC | Social Worker | 1917 W Faidley Ave, Grand Island, NE 68803-4642 | 2017-08-30 |
| 1366967010 | Fgh Inc. | Counselor | 1917 W Faidley Ave, Grand Island, NE 68803-4642 | 2017-08-03 |
| 1841712445 | Suzanne Riley Counseling, LLC | Counselor | 1917 W Faidley Ave, Grand Island, NE 68803-4642 | 2017-07-14 |
| 1558893636 | Darcy K. Dawson, Limhp, L.l.c | Community/Behavioral Health | 1917 W Faidley Ave, Grand Island, NE 68803-4642 | 2017-03-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467053884 | Christopher Patrin | Counselor | 1811 West 2nd Street, Suite 450, Grand Island, NE 68803 | 2020-11-03 |
| 1942848593 | Specialized Outpatient Services | Counselor | 1811 West 2nd Street Suite 450, Grand Island, NE 68803 | 2019-12-13 |
| 1558910604 | Grand Island Regional Medical Center | General Acute Care Hospital | 3533 Prairieview Street, Grand Island, NE 68803 | 2019-09-10 |
| 1992225817 | Destiny Mostek | Dietitian, Registered | 2201 N. Broadwell Ave, Grand Island, NE 68803 | 2017-06-21 |
| 1184150591 | Brandy Rae Bird | Registered Nurse | Mosaic Msu 2905 West 5th Street, Grand Island, NE 68803 | 2017-05-04 |
| 1831633171 | Karla Jean Sextro | Counselor | 2112 W. Faidley Ave, Grand Island, NE 68803 | 2016-12-06 |
| 1689062895 | Good Hands Clinic PC | Specialist | 524 South Webb Rd, Suite 1, Grand Island, NE 68803 | 2014-12-23 |
| 1346664554 | Lindsey M Modlin | Dental Hygienist | 4234 New York Ave, Grandi Island, NE 68803 | 2014-02-07 |
| 1568711711 | Danessa Marie Kenney | Counselor | 908 N. Howard Ave. Suite 107, Nebraska Children's Home Society, Grand Island, NE 68803 | 2012-09-04 |
| 1649528563 | Nicole Morris | Physical Therapist | 2116 Faidley Ave, Grand Island, NE 68803 | 2012-08-27 |
| Find all providers in zip 68803 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609248673 | Family Medical Care | Clinic/Center | 1300 S Locust St Ste F, Grand Island, NE 68801-8200 | 2015-10-29 |
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| 1508316720 | Regeneration P.C. | Clinic/Center | 6030 Village Dr Ste 100, Lincoln, NE 68516-4773 | 2016-10-12 |
| 1861941999 | Brad Rodgers Md Family Practice & Sports Medicine | Clinic/Center | 3500 Central Ave Ste A, Kearney, NE 68847-2963 | 2016-09-30 |
| 1053760504 | Central Nebraska Medical Clinic Arcadia | Clinic/Center | 110 West Bridge Street, Arcadia, NE 68815 | 2016-06-06 |
| 1235539750 | Dfas-jfll/in | Clinic/Center | 4005 Raynor Pkwy Apt 3316, Bellevue, NE 68123-6110 | 2014-09-03 |
| Find all providers with the same taxonomy | ||||
| City | GRAND ISLAND |
| Zip Code | 68803 |
Please comment or provide details below to improve the information on BROOKE BOGGS LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.