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Deactivated NPI 1770540353 Deactivated / Inactive NPI Female Practitioner

Mary Ellen Brooks

Licensed Practical Nurse • Dublin, GA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Mary Brooks has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date April 27, 2006
NPI Deactivation Date October 22, 2018
Total Practice Duration ~12 Years of Practice (2006 – 2018)

Professional Overview & Biography Verified Profile Summary

Mary Brooks was a registered Licensed Practical Nurse practicing in Dublin, GA. Throughout an active medical career spanning 12 years, Mary Brooks provided care at the practice location at 2121A BELLEVUE RD until profile deactivation on 2018-10-22.

Practice Location & Contact Primary Location

Practice Address

2121a Bellevue Rd

Dublin, GA 31021

Telephone 4782721190
Fax 4782756509
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Licensed Practical Nurse in Dublin, GA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.0 Yrs
Regional Practice Density
63 Specialists

Practicing in Dublin, GA (1401 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Licensed Practical Nurse Primary Specialty

NUCC Taxonomy Code: 164W00000X

State License GA LPN070051

An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Garrett Clark

Behavior Technician

NPI 1003754771
Dr. Louis Jacobs , MD

Psychiatry & Neurology - Psychiatry

NPI 1003891441

Doctor of Medicine (M.D.)

Baserine Grace , LPN

Licensed Practical Nurse

NPI 1013156132

Licensed Practical Nurse

Yolanda Campbell , LPC

Counselor - Mental Health

NPI 1013201797

Licensed Professional Counselor

Jennifer Freeman , LCSW

Social Worker - Clinical

NPI 1023093093

Licensed Clinical Social Worker

Betty Boutwell , LPN

Licensed Practical Nurse

NPI 1023095056

Licensed Practical Nurse

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated October 22, 2018

Record deactivated on October 22, 2018

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 2121A BELLEVUE RD, DUBLIN, GA 31021 (Tel: 4782721190)

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Updated Business Mailing Address July 08, 2007

Registered at 2121A BELLEVUE RD, DUBLIN, GA 31021 (Tel: 4782721190)

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Provider Name / Credentials Updated July 08, 2007

Recorded as MARY BROOKS

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Licensed Practical Nurse (License #LPN070051 in GA)

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Initial NPI Registration & Enumeration April 27, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1770540353
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 27, 2006
Last Update: July 08, 2007
Deactivation Date: October 22, 2018

Mailing Address

2121a Bellevue Rd

Dublin, GA 31021

Phone: 4782721190

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.