Derek Jason Brock, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

COA.15415-NP Issued in OH

Practice address

149 E Simpson St
Alliance, OH 44601-4219

Phone

(330) 823-3856

Fax

(330) 829-6688

NPI assigned

Nov 22, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Union Physician Services LLCGroup PAC ID 0143366591, 97 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Union Hospital Hospital, Dover, OH, CCN 360010
• Mercy Medical Center Hospital, Canton, OH, CCN 360070
• Aultman Hospital Hospital, Canton, OH, CCN 360084
• Aultman Orrville Hospital Hospital, Orrville, OH, CCN 361323
• Cleveland Clinic Hospital, Cleveland, OH, CCN 360180

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

Practice roles

Locations

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.

• Union Physician Services, LLC

  • Family Medicine Physician
  • Dover, OH
  • NPI 1215169826
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Aultman Hospital

  • General Acute Care Hospital
  • Canton, OH
  • NPI 1356366991
  Care Compare affiliation
• Cleveland Clinic Mercy Hospital

  • General Acute Care Hospital
  • Canton, OH
  • NPI 1366433195
  Care Compare affiliation
• Orrville Hospital Foundation

  • Critical Access Hospital
  • Orrville, OH
  • NPI 1891718375
  Care Compare affiliation
• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  Care Compare affiliation
• The Union Hospital Association

  • Rural Acute Care Hospital
  • Dover, OH
  • NPI 1871606921
  Care Compare affiliation

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

{
    "created_epoch": "1385078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435708800000",
    "number": "1588094882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 932100",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930008",
            "telephone_number": "216-472-2730",
            "fax_number": "216-472-2740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 E SIMPSON ST",
            "city": "ALLIANCE",
            "state": "OH",
            "postal_code": "446014219",
            "telephone_number": "330-823-3856",
            "fax_number": "330-829-6688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "DEREK",
        "middle_name": "JASON",
        "name_prefix": "Mr.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-22",
        "last_updated": "2015-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.15415-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0095680",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dana Brake, CRNA
• Morgan Lynne Brandt, LAT, ATC
• Brian Taylor Briggs, DO
• Darlene Britt
• Michelle Marie Brod, MPT
• Brookdale Senior Living Communities Inc
• Erin Brooks
• Otisia Kenyona Brooks, LPN
• Sydney Nicole Brown, PA

• Family Nurse Practitioner in Alliance, OH
• Providers in Alliance, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.