Amanda Dee Brock, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3005621 Issued in KY

Practice address

350 Langdon St
Somerset, KY 42503-2786

Phone

(606) 678-8155

Fax

(606) 678-7548

NPI assigned

Sep 5, 2008

Last updated

May 12, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cumberland Family Medical Center Inc

  dba Cumberland Family Medical Center

  • Federally Qualified Health Center (FQHC)
  • Burkesville, KY
  • NPI 1306873500
  Medicare reassignment NPD
• Cumberland Family Medical Center Inc

  dba Clinton Family Medical Center

  • Federally Qualified Health Center (FQHC)
  • Albany, KY
  • NPI 1427218023
  NPD
• Cumberland Family Medical Center Inc

  dba Metcalfe County Middle Healthy Kids Clinic

  • Federally Qualified Health Center (FQHC)
  • Edmonton, KY
  • NPI 1548953672
  NPD
• Bluegrass Clinic Liberty, PLLC

  • Family Medicine Physician
  • Liberty, KY
  • NPI 1457555146
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1220572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683849600000",
    "number": "1013165786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1080",
            "city": "BURKESVILLE",
            "state": "KY",
            "postal_code": "427171080",
            "telephone_number": "270-858-6655",
            "fax_number": "270-858-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 LANGDON ST",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425032786",
            "telephone_number": "606-678-8155",
            "fax_number": "606-678-7548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "AMANDA",
        "middle_name": "DEE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-05",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3005621",
            "primary": true
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "KY",
            "license": "5621P",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100099690",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11988299",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brighter Futures Therapy Center, LLC
• Brighter Futures Therapy Center, LLC
• Brightview LLC
• Alyssa Brittain
• Broadening Horizons, Inc.
• Jody Brock, LPN
• Sarah Nicole Brock, PHARMD
• Vickie Lane Brockman, BA
• Amanda Noelle Brooks, LPCC
• Tamela Marie Brown-Murray, O.D.

• Family Nurse Practitioner in Somerset, KY
• Providers in Somerset, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.