Individual provider Active NPI

Jana Johnson Brock, MD

  • Family Medicine Physician
  • Corsicana, TX
National Provider Identifier
1124121108
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
P0011 Issued in TX
Practice address
3108 W State Highway 22
Corsicana, TX 75110-2435
Phone
(660) 833-7554
NPI assigned
Sep 6, 2006
Last updated
Apr 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X P0011 TX Primary
Sports Medicine (Family Medicine) Physician 207QS0010X P0011 TX

Addresses

Primary practice location

3108 W State Highway 22
Corsicana, TX 75110-2435

Mailing address

3108 W State Highway 22
Corsicana, TX 75110-2435

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140908001309 TX Practitioner - Family PracticePractitioner - Sports Medicine 3375610520 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
University of Texas Medical School at Houston, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
P0011TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brock Medical, PLLC Family Medicine CurrentSince Apr 1, 2023 Accepting new patients
Regional Employee Assistance Program Inc Family Medicine CurrentSince May 1, 2020 Accepting new patients
Regional Employee Assistance Program Inc Family Medicine CurrentSince May 1, 2020 Accepting new patients
Moberly Physicians Corp Family Medicine Past Accepting new patients

Locations

301 Hospital Dr
#150
Corsicana, TX 75110
Phone (903) 641-4800

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

Interoperability endpoints

  • Direct secure messaging: jana.brock.1@28776.direct.athenahealth.com

Organizations & group practices 4

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

Hospital & facility affiliations 4

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": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1124121108",
    "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"
        },
        {
            "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": "660-833-7554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "JANA",
        "middle_name": "JOHNSON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P0011",
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "TX",
            "license": "P0011",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corsicana, TX

Sources for this page

Verify at the official NPI Registry.