Organization Active NPI

Brock Medical, PLLC

Doing business as Recover Health and Wellness

  • Family Medicine Physician
  • Corsicana, TX
National Provider Identifier
1063113991
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BROCK MEDICAL, PLLC
Doing business as
Recover Health and Wellness
Practice address
3108 W State Highway 22
Corsicana, TX 75110-2435
Phone
(903) 257-3668
Fax
(903) 213-9245
NPI assigned
Mar 16, 2023
Last updated
Apr 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2023

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

Authorized official

Name
Jana J Brock, MDNPI 1124121108
Title
Owner
Phone
(903) 257-3668

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Sports Medicine (Family Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QS0010X

Addresses

Primary practice location

3108 W State Highway 22
Corsicana, TX 75110-2435

Mailing address

3108 W State Highway 22
Corsicana, TX 75110-2435
Phone (903) 257-3668

Other names 1

  • Recover Health and Wellness Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230503000318 TX Part B Supplier - Clinic/Group Practice 8123483831 Receives reassigned benefits from 1 practitioner
Practice locations: Corsicana, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2279887Recover Health and Wellness3108 W State Hwy 22, Corsicana, TX 75110Certificate of waiverApr 9, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1678924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680480000000",
    "number": "1063113991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3108 W STATE HIGHWAY 22",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751102435",
            "telephone_number": "903-257-3668",
            "fax_number": "903-213-9245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3108 W STATE HIGHWAY 22",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751102435",
            "telephone_number": "903-257-3668",
            "fax_number": "903-213-9245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROCK MEDICAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-16",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A",
        "authorized_official_last_name": "BROCK",
        "authorized_official_first_name": "JANA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-257-3668",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Recover Health and Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Recover Health and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Corsicana, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.