Jacqueline Renita Brock-Carter

Primary specialty

Optometric Assistant TechnicianTaxonomy code 156FX1201X

Practice address

5028 Fable St
Capitol Heights, MD 20743-4019

Phone

(240) 838-1978

NPI assigned

Sep 4, 2009

Last updated

Sep 4, 2009By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1252022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252022400000",
    "number": "1396078531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5028 FABLE ST",
            "city": "CAPITOL HEIGHTS",
            "state": "MD",
            "postal_code": "207434019",
            "telephone_number": "240-838-1978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5028 FABLE ST",
            "city": "CAPITOL HEIGHTS",
            "state": "MD",
            "postal_code": "207434019",
            "telephone_number": "240-838-1978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK-CARTER",
        "first_name": "JACQUELINE",
        "middle_name": "RENITA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-04",
        "last_updated": "2009-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1201X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optometric Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brianna Blackshear
• Bertram Roy Blair
• Oreitha Bonner
• Beatrice Bouomgny Epse Mwanza
• Traon Boykin, M.S., CCC-SLP
• Jacqualine Margaret Brooks, MSW
• Kimberly R Brooks
• Connie Brown
• Hannah Olivia Brown
• Makiah D Brown

• Technician/Technologist in Capitol Heights, MD
• Providers in Capitol Heights, MD by specialty
• Technician/Technologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2009; 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.