Individual provider Active NPI

Merisha Brock

  • Primary Care Nurse Practitioner
  • Chipley, FL
National Provider Identifier
1497667406
Registry record updated Sep 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
11051077 Issued in FL
Practice address
1376 Brickyard Rd Ste 4
Chipley, FL 32428-6392
Phone
(850) 260-1649
NPI assigned
Sep 22, 2026
Last updated
Sep 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 11051077 FL Primary

Addresses

Primary practice location

1376 Brickyard Rd Ste 4
Chipley, FL 32428-6392

Mailing address

1376 Brickyard Rd Ste 4
Chipley, FL 32428-6392
Phone (850) 260-1649

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790208000000",
    "number": "1497667406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1376 BRICKYARD RD STE 4",
            "city": "CHIPLEY",
            "state": "FL",
            "postal_code": "324286392",
            "telephone_number": "850-260-1649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1376 BRICKYARD RD STE 4",
            "city": "CHIPLEY",
            "state": "FL",
            "postal_code": "324286392",
            "telephone_number": "850-260-1649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "MERISHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-22",
        "last_updated": "2026-09-24",
        "certification_date": "2026-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "11051077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chipley, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.