BROOKE WATTS (FNP) – Family Nurse Practitioner, NPI 1073344891

BROOKE WATTS (FNP) is a healthcare provider. based in Saint louis, Missouri. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP. They hold a License No. 2024032567 (MO). The NPI Number for BROOKE WATTS (FNP) is 1073344891

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
BROOKE WATTS (FNP)
NPI
1073344891
Phone
Not provided
Address
10012 KENNERLY RD STE 300
Enumeration Date
13 August 2024
Last Update Date
12 September 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3148420602
Graduation Year
2024 (2 years ago)
PAC ID
0547701039
Group Practice PAC ID
8820016207
Professional Enrollment ID
I20240924003935
Address ID
MO631282197SA10012RDXX308
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

7,017 NURSE PRACTITIONER in MO

Provider Addresses for BROOKE WATTS (FNP)

  • 10012 KENNERLY RD STE 300

    SAINT LOUIS, MO 631282197

    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: 2024-09-24

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
I20240924003935INurse PractitionerMOTBD

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 63128)

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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: 8820016207View full group profile
NameSpecialtyState
Nurse PractitionerMO
Nurse PractitionerMO
Nurse PractitionerKS
Cardiovascular Disease (Cardiology), Internal MedicineMO
Nurse PractitionerMO
-MO
Internal Medicine, Cardiovascular Disease (Cardiology), Cardiovascular Disease (Cardiology), Internal MedicineMO
Nurse PractitionerMO
-MO
Internal Medicine, Cardiovascular Disease (Cardiology)MO

Reviews

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Frequently asked questions

Is BROOKE WATTS (FNP) listed with a National Provider Identifier?
Yes — BROOKE WATTS (FNP) has NPI 1073344891 on file in the registry.
Active or inactive — what applies to BROOKE WATTS (FNP)?
You should see BROOKE WATTS (FNP) as active in CMS-hosted NPPES data.
What kind of doctor is BROOKE WATTS (FNP)?
BROOKE WATTS (FNP) is associated with Family Nurse Practitioner in the directory — Clinical services aligned with this taxonomy classification.
Is BROOKE WATTS (FNP) associated with Saint Louis?
Public fields place BROOKE WATTS (FNP) around Saint Louis, Missouri. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for BROOKE WATTS (FNP) is noted as August 13, 2024 where the registry provides it.

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