Individual provider Active NPI

Warner Brock, P.T.,CMDT, MBA, CEAS

  • Physical Therapist
  • Gainesville, GA
National Provider Identifier
1063450054
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2651 Issued in GA
Practice address
100 Spring St
Suite B
Gainesville, GA 30501-2565
Phone
(770) 532-5721
Fax
(770) 532-5929
NPI assigned
Jun 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2651 GA Primary

Addresses

Primary practice location

100 Spring St
Suite B
Gainesville, GA 30501-2565

Mailing address

100 Spring St
Suite B
Gainesville, GA 30501-2565
Phone (770) 532-5721

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041229000049 GA Practitioner - Physical Therapist in Private Practice 4880652411 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Medical College of Georgia School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

100 Spring St
Suite B
Gainesville, GA 30501-2565
Phone (770) 532-5721

34 Courthouse SQ
Cleveland, GA 30528-1178
Phone (706) 219-1330

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration

State licenses

LicenseStateTypeSpecialty
2651GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lanier Therapy in Motion Physical Therapist CurrentSince Oct 1, 2004 Accepting new patients

Locations

5005 Lanier Islands Pkwy
Ste 300
Buford, GA 30518
Phone (770) 271-3458

100 Spring St
Ste B
Gainesville, GA 30501
Phone (770) 532-5721

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1063450054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SPRING ST",
            "address_2": "SUITE B",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305012565",
            "telephone_number": "770-532-5721",
            "fax_number": "770-532-5929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SPRING ST",
            "address_2": "SUITE B",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305012565",
            "telephone_number": "770-532-5721",
            "fax_number": "770-532-5929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "WARNER",
        "credential": "P.T.,CMDT, MBA, CEAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "2651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.