NICOLE BROOKS – Family Nurse Practitioner, NPI 1093676306

NICOLE BROOKS is a healthcare provider. based in Burden, Kansas. specializing in NURSE PRACTITIONER. They hold a License No. TMP-163137 (KS). The NPI Number for NICOLE BROOKS is 1093676306

Main info

Female
1 Year Of Experience
Accepts Medicare Assignment
Name
NICOLE BROOKS
NPI
1093676306
Phone
Not provided
Address
17860 112TH RD
Enumeration Date
18 November 2025
Last Update Date
18 November 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6202210110
Graduation Year
2025 (1 year ago)
PAC ID
8527547074
Group Practice PAC ID
5294648937
Professional Enrollment ID
I20260205002125
Address ID
KS671563220WI1700XAVEX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

3,550 NURSE PRACTITIONER in KS

Provider Addresses for NICOLE BROOKS

  • 17860 112TH RD

    BURDEN, KS 670199249

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2026-02-05

PECOS data refreshed: 2026-05-27

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20260205002125INurse PractitionerKSTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 67019)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5294648937View full group profile
NameSpecialtyState
Internal MedicineKS
Internal MedicineIL
Internal MedicineKS
Certified Registered Nurse Anesthetist (Crna)KS
General SurgeryKS
Nurse PractitionerKS
Family PracticeKS
Obstetrics/Gynecology, Osteopathic Manipulative MedicineKS
Nurse PractitionerKS
Nurse PractitionerKS

Reviews

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Frequently asked questions

What is the registry number for NICOLE BROOKS?
The registry entry for NICOLE BROOKS shows NPI 1093676306.
Quick check: is NICOLE BROOKS active?
Public NPPES data shows NICOLE BROOKS with an active NPI status right now.
What services align with NICOLE BROOKS's listing?
NICOLE BROOKS's public classification highlights Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Which community is linked to NICOLE BROOKS?
NICOLE BROOKS shows a connection to Burden, Kansas in registry-derived data.
Can I export NICOLE BROOKS's record?
You can download the official NPPES record; we summarize key fields for readability.

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