Individual provider Active NPI

Margaret Anne Brock

  • Family Nurse Practitioner
  • Tifton, GA
National Provider Identifier
1104391002
Registry record updated Oct 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN228109 Issued in GA
Practice address
1948 Old Ocilla Rd
Tifton, GA 31794-1644
Phone
(229) 391-3500
Fax
(229) 391-3499
NPI assigned
Oct 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN228109 GA Primary

Addresses

Primary practice location

1948 Old Ocilla Rd
Tifton, GA 31794-1644

Mailing address

1948 Old Ocilla Rd
Tifton, GA 31794-1644
Phone (229) 391-3500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN228109GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
United Obstetrics and Gynecology, P.C. Past Accepting new patients
Womens Center for Advanced Surgery Inc Past Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Organizations & group practices 3

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": "1538784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538784000000",
    "number": "1104391002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1948 OLD OCILLA RD",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317941644",
            "telephone_number": "229-391-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1948 OLD OCILLA RD",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317941644",
            "telephone_number": "229-391-3500",
            "fax_number": "229-391-3499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "MARGARET ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-06",
        "last_updated": "2018-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN228109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tifton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2018; 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.