Active NPI
Joseph L Brock, MD
- Family Medicine Physician
- Barre, VT
National Provider Identifier
1043286594
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 042.0011623
- Practice address
- 246 Granger Rd
Suite 2
Barre, VT 05641-5344 - Phone
- (802) 225-5810
- Fax
- (802) 371-4821
- NPI assigned
- Feb 24, 2006
- Last updated
- Dec 4, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4301047460 | MI | |
| Family Medicine Physician | 207Q00000X | 042.0011623 | VT | Primary |
Addresses
Primary practice location
246 Granger Rd
Suite 2
Barre, VT 05641-5344
Mailing address
PO Box 547
Att: CVMC Finance Dept
Barre, VT 05641-0547
Phone (802) 225-5810
Other identifiers 12
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5621038 | Other | MI | AETNA |
| P00091158 | Other | MI | RAILROAD MEDICARE |
| 0806100351 | Other | MA | BLUE CROSS BLUE SHIELD |
| 0806100351 | Other | MI | BLUE CARE NETWORK |
| 101317 | Other | MI | PREFERRED CHOICES |
| 4556208 | Other | MI | MOLINA HEALTHCARE |
| 300207909004 | Other | MI | TRICARE |
| 1015396 | Medicaid | VT | |
| 6589077 | Other | MI | CIGNA |
| 34918 | Other | MA | HEALTH PLAN OF MI |
| 4556208 | Medicaid | MI | |
| A74772 | Other | MI | PRIORITY HEALTH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417651200000",
"number": "1043286594",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 547",
"address_2": "ATT: CVMC FINANCE DEPT",
"city": "BARRE",
"state": "VT",
"postal_code": "056410547",
"telephone_number": "802-225-5810",
"fax_number": "802-371-4821"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "246 GRANGER RD",
"address_2": "SUITE 2",
"city": "BARRE",
"state": "VT",
"postal_code": "056415344",
"telephone_number": "802-225-5810",
"fax_number": "802-371-4821"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROCK",
"first_name": "JOSEPH",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-24",
"last_updated": "2014-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "4301047460",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "VT",
"license": "042.0011623",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5621038",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00091158",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "0806100351",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CARE NETWORK",
"identifier": "0806100351",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED CHOICES",
"identifier": "101317",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MOLINA HEALTHCARE",
"identifier": "4556208",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "300207909004",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1015396",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "6589077",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PLAN OF MI",
"identifier": "34918",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4556208",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRIORITY HEALTH",
"identifier": "A74772",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Barre, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.