Individual provider Active NPI

William M Brock, DO

  • Family Medicine Physician
  • Hampstead, NC
National Provider Identifier
1366946576
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2021-01824 Issued in NC
Practice address
40 Ravenswood Rd
Hampstead, NC 28443-4022
Phone
(910) 772-6558
Fax
(910) 270-2290
NPI assigned
Mar 21, 2018
Last updated
Sep 5, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2021-01824 NC Primary

Addresses

Primary practice location

40 Ravenswood Rd
Hampstead, NC 28443-4022

Mailing address

1202 Medical Center Dr
Wilmington, NC 28401-7307
Phone (910) 341-1540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20210730001033 NC Practitioner - Family Practice 7315340148 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Liberty Univ College of Osteopathic Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wilmington Health PLLCGroup PAC ID 6103722509, 364 clinicians

Practice addresses (Care Compare)

1000 Brabham LN
Jacksonville, NC 28546-5003
Phone (910) 341-1540

1202 Medical Ctr Dr
Wilmington, NC 28401-7307
Phone (910) 341-1540

1222 Medical Ctr Dr
Wilmington, NC 28401-7307
Phone (910) 341-1540

8064 Market St
Wilmington, NC 28411-9384
Phone (910) 341-1540

8068 Market St
Wilmington, NC 28411-9384
Phone (910) 796-7767

8090 Market St
Wilmington, NC 28411-9384
Phone (910) 341-1540

8108 B Market St
Wilmington, NC 28411-9386
Phone (910) 341-1540

8114 Market St
Suite 200
Wilmington, NC 28411-9386
Phone (910) 341-1540

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2021-01824NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wilmington ASC LLC CurrentSince Jul 23, 2021 Accepting new patients
Wilmington Health PLLC CurrentSince Jul 23, 2021 Accepting new patients

Locations

40 Ravenswood Rd
Hampstead, NC 28443
Phone (910) 343-1031

1000 Brabham Ave
#6555
Jacksonville, NC 28546

1202 Medical Center Dr
Wilmington, NC 28401
Phone (910) 617-6705

Interoperability endpoints

  • Direct secure messaging: william.brock.p1@direct.wilmingtonhealth.nextgenshare.com

Organizations & group practices 2

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": "1521590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1366946576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 MEDICAL CENTER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017307",
            "telephone_number": "910-341-1540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 RAVENSWOOD RD",
            "city": "HAMPSTEAD",
            "state": "NC",
            "postal_code": "284434022",
            "telephone_number": "910-772-6558",
            "fax_number": "910-270-2290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "WILLIAM",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-21",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2021-01824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampstead, NC

Sources for this page

Verify at the official NPI Registry.