Individual provider Active NPI

Corinne Mary Brock, FNP-C, MPH

  • Family Nurse Practitioner
  • Longmont, CO
National Provider Identifier
1699078980
Registry record updated Aug 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.0991380-NP Issued in CO
Practice address
1925 Mountain View Ave
Longmont, CO 80501
Phone
(720) 494-3121
Fax
(720) 494-3108
NPI assigned
Dec 8, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APN.0991380-NP CO
Registered Nurse 163W00000X RN.1619905 CO
Family Nurse Practitioner 363LF0000X APN.0991380-NP CO Primary

Addresses

Primary practice location

1925 Mountain View Ave
Longmont, CO 80501

Mailing address

1925 Mountain View Ave
Longmont, CO 80501-3128
Phone (720) 494-3121

Other practice location 1

2101 Ken Pratt Blvd Ste 200
Longmont, CO 80501
Phone (303) 649-3500

Other names 1

  • Corinne Mary Sell Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20160311001123 CO Practitioner - Nurse Practitioner 1850513490 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

1925 Mountain View Ave
Longmont, CO 80501-3128
Phone (303) 776-1234

Hospital & facility affiliations

  • Longs Peak Hospital Hospital, Longmont, CO, CCN 060128
  • Medical Center of the Rockies Hospital, Loveland, CO, CCN 060119

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN.1619905COMDRegistered Nurse
APN.0991380-NPCOMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Oct 21, 2019 Accepting new patients
Clinica Campesina Family Health Services CurrentSince Jan 5, 2016 Accepting new patients
Clinica Campesina Family Health Services Current Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Oct 21, 2019 Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

1735 S Public Rd
Lafayette, CO 80026
Phone 30366530361061

1735 S Public Rd
Ste 203
Lafayette, CO 80026

1925 Mountain View Ave
Longmont, CO 80501
Phone (303) 776-1234

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

Organizations & group practices 4

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.

Hospital & facility affiliations 4

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": "1291766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1699078980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 MOUNTAIN VIEW AVE",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805013128",
            "telephone_number": "720-494-3121",
            "fax_number": "720-494-3108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 MOUNTAIN VIEW AVE",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "80501",
            "telephone_number": "720-494-3121",
            "fax_number": "720-494-3108"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2101 Ken Pratt Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Longmont",
            "state": "CO",
            "postal_code": "80501",
            "country_code": "US",
            "telephone_number": "303-649-3500",
            "fax_number": "303-649-6501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROCK",
        "first_name": "CORINNE",
        "middle_name": "MARY",
        "credential": "FNP-C, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-08",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "APN.0991380-NP",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "RN.1619905",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0991380-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CORINNE",
            "last_name": "SELL",
            "middle_name": "MARY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Longmont, CO

Sources for this page

Verify at the official NPI Registry.