Individual provider Active NPI

Aimee Nicole Brock, A.P.R.N., F.N.P.-B.C

  • Family Nurse Practitioner
  • Middlesboro, KY
National Provider Identifier
1699195883
Registry record updated Jul 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN18437 Issued in TN
Practice address
123 N 19TH St
Middlesboro, KY 40965-2865
Phone
(606) 248-2739
Fax
(606) 248-2730
NPI assigned
Apr 26, 2014
Last updated
Jul 31, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3008525 KY
Family Nurse Practitioner 363LF0000X APN18437 TN Primary

Addresses

Primary practice location

123 N 19TH St
Middlesboro, KY 40965-2865

Mailing address

2009 Nickerson Ave
Knoxville, TN 37917-3270
Phone (606) 248-2739

Other identifiers 2

IdentifierTypeStateIssuer
P01983681OtherTNRR MEDICARE
Q030733MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20180119001307 TN Practitioner - Nurse Practitioner 7517184906 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3008525KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Ambulatory Care Inc. CurrentSince Jan 3, 2022 Accepting new patients
Wellness Ambulatory Care Inc. Current Accepting new patients
Wellness Ambulatory Care Inc. CurrentSince Jan 3, 2022 Accepting new patients

Locations

412 Citico St
Knoxville, TN 37921
Phone (865) 522-0661

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1398470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564531200000",
    "number": "1699195883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2009 NICKERSON AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379173270",
            "telephone_number": "606-248-2739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 N 19TH ST",
            "city": "MIDDLESBORO",
            "state": "KY",
            "postal_code": "409652865",
            "telephone_number": "606-248-2739",
            "fax_number": "606-248-2730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "AIMEE",
        "middle_name": "NICOLE",
        "credential": "A.P.R.N., F.N.P.-B.C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-26",
        "last_updated": "2019-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3008525",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN18437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01983681",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q030733",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middlesboro, KY

Sources for this page

Verify at the official NPI Registry.