Jay David Brock, MD, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0101032059 Issued in VA

Legal business name

JAY DAVID BROCK, MD, PC

Practice address

4304 Lafayette Blvd
Fredericksburg, VA 22408-4234

Phone

(540) 891-5600

Fax

(540) 891-9034

NPI assigned

Jun 3, 2006

Organization subpart

No

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

Authorized official

Name

Jay D. Brock, M.D.

Title

Physician

Phone

(540) 891-5600

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272844800000",
    "number": "1053359968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4304 LAFAYETTE BLVD",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224084234",
            "telephone_number": "540-891-5600",
            "fax_number": "540-891-9034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4304 LAFAYETTE BLVD",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224084234",
            "telephone_number": "540-891-5600",
            "fax_number": "540-891-9034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAY DAVID BROCK, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2010-05-03",
        "status": "A",
        "authorized_official_last_name": "BROCK",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "540-891-5600",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101032059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5690803",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas Janus, D.O.
• Roy William Jarnecke, PH.D.
• Helen McLaughlin Jarrett, AGACNP
• Jason T Lipscomb DDS P C
• Shayma M. Jawad, D.O.
• Philicia Jefferson, PH.D.
• Dave Jenkins, DMIN, LMFT
• Lisa Jenkins, M.D
• Teresa Martin Jenkins, LCSW
• Jenniferthompson FNP-BC LLC

• Family Medicine Physician in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.