Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Maryanna Kathryn Brockman, PA-C, ATC

Individual provider Athletic Trainer · NPI 1912405531

Maryanna Kathryn Brockman, PA-C, ATC is a Physician Assistant in Middletown, Ohio. Graduated from Southern Illinois University School of Medicine in 2022, 4 years ago. Practices with Premier Health Specialists Inc, a 575-clinician group and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
4
Trained at
Southern Illinois University School of Medicine
Licensed in
OH
In the registry since
2018
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

See every abbreviation used in this directory →

Practice location Address checks out

275 N Breiel Blvd
Middletown, OH 45042-3807
Phone: (513) 424-7711
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 50.007758RX (OH)
Athletic Trainer Taxonomy 2255A2300X

Record details

NPI number1912405531
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C , ATC
Sole proprietorNo
NPI enumeratedJanuary 29, 2018
Last updated in NPPESAugust 19, 2025
Certification dateAugust 19, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolSOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE
Graduated 2022 (4 years in practice)
Group practice Premier Health Specialists Inc — 575 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Middletown