Chandler Brock

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-19-38576 Issued in AL

Practice address

1450 54TH St Ste C
Columbus, GA 31904-4494

Phone

(706) 221-1208

Fax

(904) 538-0713

NPI assigned

Jun 19, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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

• Appleseeds Learning Center, Inc.

  • Behavior Analyst
  • Kennesaw, GA
  • NPI 1215306550
  NPD (past)

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

{
    "created_epoch": "1560902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581465600000",
    "number": "1063072239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10175 FORTUNE PKWY UNIT 903",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566755",
            "telephone_number": "904-538-0713",
            "fax_number": "904-538-0714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 54TH ST STE C",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319044494",
            "telephone_number": "706-221-1208",
            "fax_number": "904-538-0713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "CHANDLER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-19",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "AL",
            "license": "1-19-38576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Malena Lauren Brissett, LPN
• Valerie Britt
• Britton-Bo LLC
• Victoria Broadhurst
• Nyssa Broadnex
• Dawn Brock
• Taylor Mackenzie Brock
• Brodwyn Military Chiropractic
• Brodwyn Spine Center LLC
• Ivan Jay Brodwyn, DC

• Behavior Analyst in Columbus, GA
• Providers in Columbus, GA by specialty
• Behavior Analyst in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2020; 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.