Gerald K Brocker Jr., MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

MD22077 Issued in TN

Practice address

975 E. Third Street
Chattanooga, TN 37403-2147

Phone

(423) 602-8400

Fax

(423) 602-8401

NPI assigned

Aug 24, 2006

Last updated

Nov 10, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478736000000",
    "number": "1669589776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2930",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462062930",
            "telephone_number": "844-468-9496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 E. THIRD STREET",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032147",
            "telephone_number": "423-602-8400",
            "fax_number": "423-602-8401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKER",
        "first_name": "GERALD",
        "middle_name": "K",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2016-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TN",
            "license": "MD22077",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "043334",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF TN",
            "identifier": "3038764",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000500596A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q002744",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009204600",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "050047698",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890692T",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE (GA MEDICAID)",
            "identifier": "N348394",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul A Broadstone, M.D.
• Erin Brock
• Karen Chaumcey Brock
• Karla F Brock, PH.D.
• Maureen White Brock, FNP-C
• Lester Jay Brodie, MD
• Kirk Warren Brody, M.D.
• James Brogan, CRNA
• Saundra Lynn Brogan, MSPT
• Brogdon Dental PC

• Anesthesiology Physician in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Anesthesiology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.