Individual provider Active NPI

Naklesa Tonette Brock, FNP-C

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1609402429
Registry record updated Mar 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3013868 Issued in KY
Practice address
1403 Cloverhills Dr
Louisville, KY 40216-4027
Phone
(502) 759-3381
NPI assigned
Mar 13, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2020

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 3013868 KY Primary

Addresses

Primary practice location

1403 Cloverhills Dr
Louisville, KY 40216-4027

Mailing address

1403 Cloverhills Dr
Louisville, KY 40216-4027
Phone (502) 759-3381

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20220210001476 KY Practitioner - Nurse Practitioner 1456744614 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2746 Virginia Ave
Louisville, KY 40211-3417
Phone (502) 815-7040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3013868KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. Family CurrentSince Mar 1, 2022 Accepting new patients
University of Louisville Physicians, Inc. Current Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Aug 14, 2024 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Aug 14, 2024 Accepting new patients
Community Medical Associates, Inc. CurrentSince Mar 1, 2022 Accepting new patients
University of Louisville Physicians, Inc. Past Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

4423 Bardstown Rd
Louisville, KY 40218
Phone (502) 495-2400

2746 Virginia Ave
Louisville, KY 40211
Phone (502) 772-1883

7926 Preston Hwy
Ste 106
Louisville, KY 40219
Phone (502) 964-4357

12903 Shelbyville Rd
Louisville, KY 40243
Phone (502) 244-5827

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

9409 Shelbyville Rd
Ste 104
Louisville, KY 40222
Phone (502) 588-0740

1707 Cedar Grove Rd
Ste 10
Shepherdsville, KY 40165
Phone (502) 543-3246

Interoperability endpoints

  • Direct secure messaging: nbrock44678@uoflhealth-dm.org
  • Direct secure messaging: nbrock228149@direct.nortonhealthcare.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1584057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1609402429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1403 CLOVERHILLS DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402164027",
            "telephone_number": "502-759-3381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1403 CLOVERHILLS DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402164027",
            "telephone_number": "502-759-3381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "NAKLESA",
        "middle_name": "TONETTE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-13",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3013868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.