Individual provider Active NPI

Laney Elizabeth Brock, FNP-BC

  • Family Nurse Practitioner
  • Oxford, MS
National Provider Identifier
1508639907
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
906355 Issued in MS
Practice address
2222 Jackson Ave W
Oxford, MS 38655-5409
Phone
(662) 380-5560
NPI assigned
Nov 7, 2023
Last updated
Nov 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 906355 MS Primary

Addresses

Primary practice location

2222 Jackson Ave W
Oxford, MS 38655-5409

Mailing address

498 Hillcrest Cir
Cleveland, MS 38732-2008
Phone (662) 719-8197

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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

Enrollment IDStateProvider typePAC IDDetails
I20240815003568 MS Practitioner - Nurse Practitioner 5092253450 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Webb Family Medical Clinic PLLCGroup PAC ID 8022442128, 2 clinicians

Practice addresses (Care Compare)

1200 Central St
Water Valley, MS 38965-1904
Phone (662) 714-4460

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
906355MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Boa Vida Hospital of Aberdeen, Ms LLC CurrentSince May 15, 2025 Accepting new patients
Boa Vida Hospital of Aberdeen, Ms, LLC CurrentSince Dec 20, 2025 Accepting new patients
Webb Family Medical Clinic PLLC CurrentSince Aug 1, 2024 Accepting new patients
Boa Vida Hospital of Aberdeen, Ms, LLC Current Accepting new patients
Boa Vida Hospital of Aberdeen, Ms LLC Past Accepting new patients
Boa Vida Hospital of Aberdeen, Ms, LLC Past Accepting new patients
Boa Vida Hospital of Aberdeen, Ms LLC Past Accepting new patients

Locations

10996 Four Seasons Pl
Ste 100C
Crown Point, IN 46307
Phone (219) 228-4355

400 S Chestnut St
Aberdeen, MS 39730
Phone (662) 369-2455

1200 Central St
Water Valley, MS 38965
Phone (662) 714-4460

405 N Main St
Water Valley, MS 38965
Phone (662) 714-4460

Organizations & group practices 7

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 2

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": "1699315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1508639907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "498 HILLCREST CIR",
            "city": "CLEVELAND",
            "state": "MS",
            "postal_code": "387322008",
            "telephone_number": "662-719-8197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 JACKSON AVE W",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555409",
            "telephone_number": "662-380-5560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "LANEY",
        "middle_name": "ELIZABETH",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-07",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "906355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, MS

Sources for this page

Verify at the official NPI Registry.