Bonnie Lynn Brock, MPH, RD, LDN, NMD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

164006979 Issued in IL

Practice address

13951 N Scottsdale Rd Ste 110
Scottsdale, AZ 85254-3454

Phone

(480) 702-1537

NPI assigned

Jan 24, 2017

Last updated

Oct 5, 2021By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Acacia Natural Medicine PLLC

  • Naturopath
  • Scottsdale, AZ
  • NPI 1184213993

  Dietitian, Registered

  NPD Authorized official
• A New Leaf Natural Medicine LLC

  • Registered Dietitian
  • Evanston, IL
  • NPI 1104306240
  Authorized official Same address or phone
• PHC of Buffalo Grove Clinical Psychology

  dba Portrait Health Centers

  • Psychologist
  • Vernon Hills, IL
  • NPI 1235430612

  Dietitian, Registered

  NPD (past)

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

{
    "created_epoch": "1485216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1285171504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6501 E GREENWAY PKWY # 103-602",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852542025",
            "telephone_number": "847-903-0503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13951 N SCOTTSDALE RD STE 110",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852543454",
            "telephone_number": "480-702-1537"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "708 Church St",
            "address_purpose": "LOCATION",
            "city": "Evanston",
            "state": "IL",
            "postal_code": "60201",
            "country_code": "US",
            "telephone_number": "847-903-0503",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROCK",
        "first_name": "BONNIE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "MPH, RD, LDN, NMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-24",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164006979",
            "primary": true
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "AZ",
            "license": "20-1917",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittney March All Into Therapy LLC
• Christina Jennifer Britton, MS CCC-SLP
• Brandon Brizel, LMSW
• Erik W Brizzee, AU.D., CCC-A
• Jourdan Elizabeth Broadfoot, MD
• Jennifer Brodie, N.P.
• Michael Jarrett Brodkin, P.A.
• Tara L Brodkin, MD
• Kyle R Brody, LPC
• Martin Broermann, D.D.S.

• Registered Dietitian in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Registered Dietitian in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; 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.