Brock Ackerman, ATC

Primary specialty

Sports Medicine (Emergency Medicine) PhysicianTaxonomy code 207PS0010X

License

AL6300 Issued in FL

Practice address

960 Learning Way
Tallahassee, FL 32306-0001

Phone

(850) 644-0570

NPI assigned

Jul 10, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1295413128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 N BRONOUGH ST",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323036008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 LEARNING WAY",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323060001",
            "telephone_number": "850-644-0570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACKERMAN",
        "first_name": "BROCK",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PS0010X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": "FL",
            "license": "AL6300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Tallahassee, FL
• Sports Medicine (Emergency Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; 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.