MS. CAMILLE TISHA BROCKETT (NP) – Acute Care Nurse Practitioner, NPI 1902079957
Acute Care Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
9,744 NURSE PRACTITIONER in GA
Provider Addresses for MS. CAMILLE TISHA BROCKETT (NP)
4805 IVY RIDGE DR SE UNIT 203
SMYRNA, GA 300806659
Phone:
Type: Mailing
2224 AUSTIN LAKE DR SE
SMYRNA, GA 300823380
Phone:
Type: Mailing
EMORY UNIVERSITY HOSPITAL EMERGENCY DEPARTMENT
1364 CLIFFTON ROAD
ATLANTA, GA 303221006
Phone: (404) 712-2000
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $125.
Total Amount is formed as General ($125) + Research ($0) + Ownership ($0) = $125.
Last reported payment date: 2024-08-16 • Largest payer in this snapshot: ABBVIE INC. ($77).
Total Amount
$125
General + Research + Ownership
Payments
3
Total payment records
General Amount
$125
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $77 |
| REVANCE THERAPEUTICS, INC. | $48 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2008-06-10
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20080610000226 | I | Nurse Practitioner | GA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99291 | Critical care, first 30-74 minutes | 31 | 23 | $0 |
Insurance plans in this area (ZIP 30080)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Clinical Nurse Specialist (Cns) | GA | |
| Nurse Practitioner | GA | |
| - | GA | |
| Nurse Practitioner | GA | |
| - | GA | |
| - | GA | |
| Certified Registered Nurse Anesthetist (Crna) | GA | |
| - | NY | |
| - | GA | |
| Nurse Practitioner | MI |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.