Jessica Marie Brock, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

3008731 Issued in KY

Practice address

148 Commercial Dr
London, KY 40744-8204

Phone

(606) 260-8532

Fax

(606) 260-8534

NPI assigned

Jun 10, 2014

Last updated

Nov 7, 2024By 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

Enrolled in KY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/3044/brand/1/csg/1/fhir/r4

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.

• Ascend Wellness, LLC

  • Mental Health Counselor
  • London, KY
  • NPI 1619725579
  Medicare reassignment NPD
• Family Health Care Clinic PSC

  • Rural Health Clinic/Center
  • Richmond, KY
  • NPI 1073717286

  Family

  Medicare reassignment NPD
• Family Practice Clinic of Booneville, Inc.

  • Rural Health Clinic/Center
  • Booneville, KY
  • NPI 1326152109
  Medicare reassignment NPD
• Lancaster Family Health Care

  • Rural Health Clinic/Center
  • Lancaster, KY
  • NPI 1942946710
  Medicare reassignment NPD
• Mountain Family Practice Clinic of Manchester Inc

  • Rural Health Clinic/Center
  • Manchester, KY
  • NPI 1689919078
  Medicare reassignment NPD
• Fuse Medical

  • Nurse Practitioner
  • London, KY
  • NPI 1164003125
  Medicare reassignment
• Jackson County Clinic, LLC

  • Rural Health Clinic/Center
  • McKee, KY
  • NPI 1942064134
  NPD (past)

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

{
    "created_epoch": "1402358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1295148914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 COMMERCIAL DR",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407448204",
            "telephone_number": "606-260-8532",
            "fax_number": "606-260-8534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 COMMERCIAL DR",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407448204",
            "telephone_number": "606-260-8532",
            "fax_number": "606-260-8534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-10",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3008731",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3008731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marc Briere, MD
• Brightview LLC
• Brenda Brison, MED, TCM, TCADC
• Brock Medical, LLC (First Care Clinics, LLC)
• Dereni Blake Brock, PT
• Nadine Brock, APRN
• Olivia Anne Brock, CRNA
• Stephanie Ann Brock, LCADC
• Kevin Brooks, PA
• Marietta Brooks, APRN

• Psychiatric/Mental Health Nurse Practitioner in London, KY
• Providers in London, KY by specialty
• Psychiatric/Mental Health Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.