Brock Minor

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

APRN.CRNA.0020602 Issued in OH

Practice address

433 W High St
Bryan, OH 43506-1690

Phone

(419) 636-1131

Fax

(419) 636-3100

NPI assigned

Aug 8, 2022

Last updated

Oct 3, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Group practices

Clinical Colleagues IncGroup PAC ID 8729011333, 170 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Hospitals and Wellness Centers Hospital, Bryan, OH, CCN 360121

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Clinical Colleagues LLC

  • Anesthesiology Physician
  • Van Wert, OH
  • NPI 1992725766

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD

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

• Community Hospitals and Wellness Centers

  • General Acute Care Hospital
  • Bryan, OH
  • NPI 1962458521
  Care Compare affiliation

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

{
    "created_epoch": "1659916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1245968320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 W HIGH ST",
            "city": "BRYAN",
            "state": "OH",
            "postal_code": "435061690",
            "telephone_number": "419-636-1131",
            "fax_number": "419-636-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 W HIGH ST",
            "city": "BRYAN",
            "state": "OH",
            "postal_code": "435061690",
            "telephone_number": "419-636-1131",
            "fax_number": "419-636-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINOR",
        "first_name": "BROCK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-08",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "APRN.CRNA.0020602",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "OH",
            "license": "RN.452752",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Midwest Community Health Associates, Inc.
• Becky Jo Miller
• Kimberly Jo Miller, OTR
• Mark Anthony Miller
• Kyle Mills
• Emily Monroe, LISW
• Brooke E Moore, APRN.CNP
• Sean Moran, D.C., M.S.
• Kathleen Ann Moreau, M.A.,L.P.C.C.,LMHC
• Katie Sue Moreland, PTA

• Certified Registered Nurse Anesthetist in Bryan, OH
• Providers in Bryan, OH by specialty
• Certified Registered Nurse Anesthetist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; 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.