Chasity Cowart Brock, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN177270 Issued in GA

Practice address

222 Gordon St
Bremen, GA 30110-1519

Phone

(770) 537-1234

Fax

(770) 537-1234

NPI assigned

May 10, 2013

Sex

Female

Sole proprietor

No

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• 3:16 Urgent Care LLC

  • Urgent Care Clinic/Center
  • Bremen, GA
  • NPI 1295695781

  GA

  Medicare reassignment NPD
• 316 Family Medicine

  • Family Medicine Physician
  • Bremen, GA
  • NPI 1861915647

  GA

  Medicare reassignment

Medicare fee-for-service enrollment

Enrolled in GA

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

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: chasity.brock.1@22071.direct.athenahealth.com

• Ms. Chasity Cowart Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 19, 2019.

{
    "created_epoch": "1368144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568851200000",
    "number": "1407291925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 GORDON ST",
            "city": "BREMEN",
            "state": "GA",
            "postal_code": "301101519",
            "telephone_number": "770-537-1234",
            "fax_number": "770-537-1237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 GORDON ST",
            "city": "BREMEN",
            "state": "GA",
            "postal_code": "301101519",
            "telephone_number": "770-537-1234",
            "fax_number": "770-537-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "CHASITY",
        "middle_name": "COWART",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-10",
        "last_updated": "2019-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN177270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.316Healthcare.us",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "patientportal",
            "address_1": "222 Gordon St",
            "city": "Bremen",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301101519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CHASITY",
            "last_name": "COWART",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• All providers in Bremen, GA
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2019; 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.