MICHAEL K BROCKETT (NPI# 1366419343) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366419343 |
| Entity Type | Individual |
| Full Name | MICHAEL K BROCKETT |
| Credential | MD |
| Practice Address |
300 E 8th St Suite 120 Marietta OH 45750-3379 |
| Mailing Address |
Po Box 449 Marietta OH 45750-0449 |
| Practice Telephone | 7403744273 |
| Practice Fax Number | 7403765098 |
| Mailing Telephone | 7403744500 |
| Mailing Fax Number | 7403745887 |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2020-08-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 35043094 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 0056463000 | 05 | |
| OH | 0433150 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588835573 | Michael Brockett | Physician Assistant | 631 Professional Dr, Suite 360, Lawrenceville, GA 30046-3367 | 2008-03-18 |
| Street Address |
300 E 8TH ST SUITE 120 |
| City | MARIETTA |
| State | OH |
| Zip Code | 45750-3379 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891152930 | Elishah Wilthew | Physician Assistant | 300 E 8th St, Suite 121, Marietta, OH 45750-3379 | 2016-01-20 |
| 1356425565 | Jane A Niswonger | Nurse Practitioner | 300 E 8th St, Suite 120, Marietta, OH 45750-3379 | 2006-10-24 |
| 1720160773 | Peggy S West | Nurse Practitioner | 300 E 8th St, Suite 120, Marietta, OH 45750-3379 | 2006-10-19 |
| 1871561472 | Kenneth J Leopold | Family Medicine | 300 E 8th St, Suite 120, Marietta, OH 45750-3379 | 2006-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073111654 | Mary V Byrd | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 37 Sterling Rd, Marietta, OH 45750 | 2020-10-15 |
| 1356997522 | Jeffry Todd Arthur | Pharmacist | 401 Matthew Street Suite 100, Marietta, OH 45750 | 2019-08-14 |
| 1164965752 | Jennifer Ann Simmons | Counselor | 121 Putnam St, Marietta, OH 45750 | 2016-11-30 |
| 1811449010 | Kaylee Rebecca-ann Weihl | Counselor | 207 D Colegate Drive, Marietta, OH 45750 | 2016-11-04 |
| 1467802181 | Jody Alden | Registered Nurse | 342 Muskingum Dr., Marietta, OH 45750 | 2016-06-14 |
| 1073998944 | Rise A. Gibson | Dental Hygienist | 342 Muskingum Drive, Marietta, OH 45750 | 2015-07-21 |
| 1639559602 | Washington County Board of Developmental Dissabilities | Day Training, Developmentally Disabled Services | 1701 Colegate Dr., Marietta, OH 45750 | 2015-06-04 |
| 1902290406 | Irina Catanescu | Emergency Medicine | 401 Matthew Street, Emergency Department, Marietta, OH 45750 | 2015-03-23 |
| 1134520356 | Susan Jahn | Occupational Therapist | 1338a Colegate Dr, Marietta, OH 45750 | 2014-09-08 |
| 1740696087 | Melissa D Maston | Registered Nurse | Express Care - Marietta, 800 Pike St Ste 2, Marietta, OH 45750 | 2014-07-08 |
| Find all providers in zip 45750 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053885327 | Clinica De La Salud Smyrna, Inc | Family Medicine | 1815 S Cobb Dr Se Ste 101, Marietta, GA 30060-4958 | 2019-01-19 |
| 1033689351 | H&h Weight Loss LLC | Family Medicine | 3600 Dallas Hwy Sw Ste 210, Marietta, GA 30064-1687 | 2018-11-29 |
| 1801380886 | Virginia Hinton | Family Medicine | 1738 Bertram Ln Sw, Marietta, GA 30008-4138 | 2018-06-21 |
| 1285145573 | Mitchell Scott Nudelman | Family Medicine | 577 Seminole Dr Ne, Marietta, GA 30060-1507 | 2017-10-13 |
| 1740649771 | Christine Morris | Family Medicine | 141 Lacy St Nw Ste 100, Marietta, GA 30060-1117 | 2016-02-18 |
| 1891110268 | Edith I. Okoi Chukwunyere | Family Medicine | 2337 Goodwood Dr Sw, Marietta, GA 30064-4335 | 2014-02-21 |
| 1629407549 | Candace M. Walker | Family Medicine | 3707 Largent Way, Well Star West Cobb Family Practice, Marietta, GA 30064 | 2013-11-01 |
| 1982959987 | Norman Glenn Marvin | Family Medicine | 4220 Lower Roswell Rd, Unit #7300, Marietta, GA 30068-4128 | 2012-07-17 |
| 1457626855 | Gena Marie Mastrogianakis | Family Medicine | 3595 Canton Rd Ste 116-289, Marietta, GA 30066-2658 | 2012-03-19 |
| 1710271010 | Roland Ngwang | Family Medicine | 2698 Foxglove Dr Sw, Marietta, GA 30064-4546 | 2011-06-03 |
| Find all providers in MARIETTA | ||||
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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.