Individual provider Active NPI

Brian Ipock, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Franklin, TN
National Provider Identifier
1457076101
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
10025665 Issued in OR
Practice address
2010 Quail Hollow Cir
Franklin, TN 37067-5967
Phone
(615) 807-4020
Fax
(615) 771-6337
NPI assigned
Oct 5, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 10025665 OR Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 34199 TN

Addresses

Primary practice location

2010 Quail Hollow Cir
Franklin, TN 37067-5967

Mailing address

2010 Quail Hollow Cir
Franklin, TN 37067-5967
Phone (615) 817-3130

Other practice location 1

1225 NE 2nd Ave
Portland, OR 97232-2003
Phone (503) 944-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230901000800 TN Practitioner - Nurse Practitioner 2567832447 Reassigns benefits to 1 organization
I20250117002513 OR Practitioner - Nurse Practitioner 2567832447 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Emanuel Hospital and Health CenterGroup PAC ID 4587573639, 235 clinicians

Practice addresses (Care Compare)

1225 NE 2ND Ave
Portland, OR 97232-2003
Phone (503) 944-8000

Hospital & facility affiliations

  • Legacy Emanuel Medical Center Hospital, Portland, OR, CCN 380007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rolling Hills Hospital LLC CurrentSince Aug 1, 2023 Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Jan 15, 2025 Accepting new patients
Path Psychiatry PLLC Psychiatric/Mental Health CurrentSince Jun 23, 2023 Accepting new patients
Legacy Emanuel Hospital & Health Center Current Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Jan 15, 2025 Accepting new patients

Locations

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

1225 NE 2nd Ave
Portland, OR 97232
Phone (503) 413-5051

2014 Quail Hollow Cir
Franklin, TN 37067
Phone (615) 250-6700

2010 Quail Hollow Cir
Franklin, TN 37067
Phone (615) 807-4020

Organizations & group practices 5

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.

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": "1664928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1457076101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 QUAIL HOLLOW CIR",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370675967",
            "telephone_number": "615-817-3130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 QUAIL HOLLOW CIR",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370675967",
            "telephone_number": "615-807-4020",
            "fax_number": "615-771-6337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1225 NE 2nd Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972322003",
            "country_code": "US",
            "telephone_number": "503-944-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IPOCK",
        "first_name": "BRIAN",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-05",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "10025665",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "34199",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin, TN

Sources for this page

Verify at the official NPI Registry.