Philip M Brock, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3881 Issued in TN

Practice address

15 Iris LN
Crossville, TN 38555-7528

Phone

(931) 456-2728

Fax

(931) 456-5446

NPI assigned

Mar 8, 2024

Last updated

Jun 25, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eye Centers of Tennessee, LLCGroup PAC ID 1355379256, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pbrock@ecotn.intellechartdirect.net

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.

• Eye Centers of Tennessee, LLC

  • Ophthalmology Physician
  • Crossville, TN
  • NPI 1104940790

  Optometrist

  Medicare reassignment Care Compare group NPD
• Eye Centers of Tennessee, LLC

  • Optometrist
  • Cookeville, TN
  • NPI 1548013832
  NPD

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

{
    "created_epoch": "1709856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1043078611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 IRIS LN",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385557528",
            "telephone_number": "931-456-2728",
            "fax_number": "931-456-5446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 IRIS LN",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385557528",
            "telephone_number": "931-456-2728",
            "fax_number": "931-456-5446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "PHILIP",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-08",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "3881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian B Dubes OD PC
• Brighter Beginnings
• Frank Brindisi, D.C.
• Janie Ruth Bristol, R.N
• James Cecil Bristow
• Tim Ray Brockett
• Jessica Brooks
• Beau Lyndon Broussard, DMD
• Angela Lynn Brown, FNP-BC
• Barry J Brown, M.D.

• Optometrist in Crossville, TN
• Providers in Crossville, TN by specialty
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.