Individual provider Active NPI

Sylvia Eunice Brock

  • General Practice Physician
  • Chewelah, WA
National Provider Identifier
1649589904
Registry record updated Feb 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
16251 Issued in WA
Practice address
3302 Mountainview Rd
Chewelah, WA 99109-9642
Phone
(509) 675-0758
NPI assigned
Oct 4, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 16251 WA Primary

Addresses

Primary practice location

3302 Mountainview Rd
Chewelah, WA 99109-9642

Mailing address

3302 Mountainview Rd
Chewelah, WA 99109-9642
Phone (509) 675-0758

Other names 1

  • Dr. Sylvia Eunice Brock Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16251WAMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1286150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361491200000",
    "number": "1649589904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3302 MOUNTAINVIEW RD",
            "city": "CHEWELAH",
            "state": "WA",
            "postal_code": "991099642",
            "telephone_number": "509-675-0758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3302 MOUNTAINVIEW RD",
            "city": "CHEWELAH",
            "state": "WA",
            "postal_code": "991099642",
            "telephone_number": "509-675-0758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "SYLVIA",
        "middle_name": "EUNICE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-04",
        "last_updated": "2013-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "WA",
            "license": "16251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SYLVIA",
            "last_name": "BROCK",
            "middle_name": "EUNICE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Chewelah, WA

Sources for this page

Verify at the official NPI Registry.