Individual provider Active NPI

La-Urshalar B Brock, CNM, FNP-BC

  • Family Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1073764981
Registry record updated Oct 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN 167836 Issued in GA
Practice address
1365 Clifton Rd NE BLDG C
Suite 2126
Atlanta, GA 30322-1013
Phone
(404) 778-1900
NPI assigned
Oct 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN 167836 GA Primary
Advanced Practice Midwife 367A00000X RN167836 GA

Addresses

Primary practice location

1365 Clifton Rd NE BLDG C
Suite 2126
Atlanta, GA 30322-1013

Mailing address

1365 Clifton Rd NE BLDG C
Suite 2126
Atlanta, GA 30322-1013
Phone (404) 778-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110621000325 GA Practitioner - Nurse Practitioner 5395923452 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Emory University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Practice addresses (Care Compare)

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525

Hospital & facility affiliations

  • Emory University Hospital Hospital, Atlanta, GA, CCN 110010
  • Emory University Hospital Midtown Hospital, Atlanta, GA, CCN 110078
  • Emory Johns Creek Hospital Hospital, Johns Creek, GA, CCN 110230
  • Saint Joseph'S Hospital of Atlanta, Inc Hospital, Atlanta, GA, CCN 110082
  • Emory Decatur Hospital Hospital, Decatur, GA, CCN 110076

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN 167836GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc CurrentSince Sep 2, 2014 Accepting new patients
Emory Medical Care Foundation Inc Current Accepting new patients
Minuteclinic LLC Family CurrentSince Jun 17, 2011 Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Sep 2, 2014 Accepting new patients
The Emory Clinic Inc CurrentSince Apr 22, 2013 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

1365 Clifton Rd NE
Bldg C
Atlanta, GA 30322
Phone (404) 778-3307

80 Butler St SE
Atlanta, GA 30368
Phone (404) 327-5920

101 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 778-4889

5095 Peachtree Pkwy
Norcross, GA 30092
Phone (770) 209-9299

11710 Alpharetta Hwy
Roswell, GA 30076
Phone (770) 754-0141

Interoperability endpoints

  • Direct secure messaging: lbrock19631@direct.emory.org

Organizations & group practices 6

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1223510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381190400000",
    "number": "1073764981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1365 CLIFTON RD NE BLDG C",
            "address_2": "SUITE 2126",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221013",
            "telephone_number": "404-778-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1365 CLIFTON RD NE BLDG C",
            "address_2": "SUITE 2126",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221013",
            "telephone_number": "404-778-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "LA-URSHALAR",
        "middle_name": "B",
        "name_prefix": "Miss",
        "credential": "CNM, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-09",
        "last_updated": "2013-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN 167836",
            "primary": true
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "GA",
            "license": "RN167836",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.