DR. JUSTIN MARK BROOKS (NPI# 1659682524) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659682524 |
| Entity Type | Individual |
| Full Name | DR. JUSTIN MARK BROOKS |
| Credential | M.D. |
| Practice Address |
3050 Montvale Dr Ste A Springfield IL 62704-6924 |
| Mailing Address |
2040 W Iles Ave Ste C Springfield IL 62704-4183 |
| Practice Telephone | 2177268096 |
| Mailing Telephone | 2177890668 |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2020-11-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 125.057595 | IL | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
2015004433 | MO | Allopathic & Osteopathic Physicians |
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
036132246 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036132246 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7900 Lees Summit Rd, Kansas City, MO 641391236 | 8164040690 | |
| 2301 Holmes St, Kansas City, MO 641082640 | 8164040690 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104168590 | Justin Ryan Brooks | General Practice | 11500 Lipscomb Way, White Marsh, MD 21162 | 2013-03-23 |
| 1033494570 | Justin Brooks | Pharmacist | 4056 Meander Pl Unit 201, Rockledge, FL 32955-5277 | 2011-10-17 |
| 1962026096 | Justin Brent Brooks | Nurse Anesthetist, Certified Registered | 101 E Wood St, Spartanburg, SC 29303-3040 | 2020-06-04 |
| 1811207335 | Justin Thomas Brooks | Physician Assistant | 225 Baldwin Ave, Charlotte, NC 28204-3109 | 2010-10-18 |
| Street Address |
3050 MONTVALE DR STE A |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62704-6924 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164484846 | Stephanie Heather Swope | Radiology | 3050 Montvale Dr Ste A, Springfield, IL 62704-6924 | 2006-04-06 |
| 1821350455 | Aaron P Gould | Radiology | 3050 Montvale Dr Ste A, Springfield, IL 62704-6924 | 2012-06-11 |
| 1700172905 | Robert John Talbert | Radiology | 3050 Montvale Dr Ste A, Springfield, IL 62704-6924 | 2011-06-26 |
| 1215235361 | Arpit A Patel | Radiology | 3050 Montvale Dr Ste A, Springfield, IL 62704 | 2011-03-13 |
| 1194040634 | Lucas Kyle Buckley | Radiology | 3050 Montvale Dr Ste A, Springfield, IL 62704-6924 | 2010-03-27 |
| 1912232422 | Alexander Ryan | Radiology | 3050 Montvale Dr Ste A, Springfield, IL 62704-6924 | 2009-10-16 |
| 1710117577 | Jason Michael Cox | Radiology | 3050 Montvale Dr Ste A, Springfield, IL 62704-6924 | 2009-07-15 |
| 1003044819 | Christopher John Norbet | Radiology | 3050 Montvale Dr Ste A, Springfield, IL 62704-6924 | 2009-06-30 |
| 1154556520 | Andrew Barina | Radiology | 3050 Montvale Dr Ste A, Springfield, IL 62704-6924 | 2009-05-28 |
| 1811131089 | Minesh Suresh Patel | Radiology | 3050 Montvale Dr Ste A, Springfield, IL 62704-6924 | 2009-05-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902394901 | Hillary Haaker | Occupational Therapist | 2035 W Iles, Suite C, Springfield, ID 62704 | 2018-04-25 |
| 1871095364 | Edward Doyle Slifer Sr. | Pathology | 2117 Greenside Drive, Spring Field, IL 62704 | 2018-03-01 |
| 1598263345 | Santarelli & Feller Dental Group | Dentist | 1140 Rickard Road, Suite B, Springfield, IL 62704 | 2018-01-26 |
| 1447774757 | Lisa Ann Rogers | Developmental Therapist | 2101 Lexington Dr, Apt 3, Springfield, IL 62704 | 2017-07-28 |
| 1730611286 | Mindi Rowe | Occupational Therapist | 2508 County Rd 4 1/2 E, Springfield, IL 62704 | 2017-04-03 |
| 1366992208 | Jayme Jordan | Contractor | 2409 Westchester Blvd, Springfield, IL 62704 | 2016-10-04 |
| 1154793974 | Dina Payne | Social Worker | 917 Clocktower Drive, Suite 600, Springfield, IL 62704 | 2015-10-21 |
| 1770959819 | James R Reynolds | Hearing Instrument Specialist | 2347 W Monroe St, Springfield, IL 62704 | 2015-08-12 |
| 1336576495 | Emily Jane Dungey | Counselor | 920 S Spring St Ste 1300, Springfield, IL 62704 | 2013-10-03 |
| 1942552161 | Jeannie Marie Hundley | Specialist/Technologist, Other | 2921 Monvale Drive, Springfield, IL 62704 | 2012-10-11 |
| Find all providers in zip 62704 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407389596 | Medical Mile Imaging | Radiology | 3905 E Windsmore Dr, Springfield, MO 65802 | 2017-04-06 |
| 1154738961 | Allison Kate Retzer | Radiology | 701 N 1st Box 101, Springfield, IL 62781-0001 | 2014-07-14 |
| 1134552821 | Clinical Radiologists, S.c. | Radiology | 2812 Pat Tillman Dr, Springfield, IL 62711-6410 | 2013-08-16 |
| 1700199668 | Telerad of Mo Account Management, LLC | Radiology | 5117 S. Neffleton Ave, Springfield, MO 65810 | 2010-07-21 |
| 1982915302 | William Leland Zelkovich | Radiology | 701 N 1st, Springfield, IL 62702 | 2010-06-30 |
| 1316108434 | Michael C Snyder | Radiology | 2201 Greenside Dr, Springfield, IL 62704-3245 | 2008-06-20 |
| 1245416536 | Mary T Peter | Radiology | Springfield Radiologists St Johns Hospital, 800 E. Carpenter Street, Springfield, IL 62769-0001 | 2008-01-16 |
| 1437361060 | Kal Dulaimy | Radiology | 1350 Main Street Suite 1007, Radiology and Imaging, Inc., Springfield, MA 01103-0000 | 2007-05-04 |
| 1265654164 | Nzeadibenma O Uzochukwu | Radiology | 800 Carpenter St, Springfield, IL 62769-0001 | 2007-05-02 |
| 1396865838 | Charles X Stricker | Radiology | 4303 E Lori Lei Ct, Springfield, MO 65809-3501 | 2007-03-29 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62704 |
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| 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.