Individual provider Active NPI

Julie C. Brock, O.D.

  • Optometrist
  • Saltillo, MS
National Provider Identifier
1720053952
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
661 Issued in MS
Practice address
107A Town Creek Dr
Saltillo, MS 38866-7947
Phone
(662) 869-1779
Fax
(662) 869-3776
NPI assigned
Feb 21, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 661 MS Primary
Optometrist 152W00000X 2280 TN

Addresses

Primary practice location

107A Town Creek Dr
Saltillo, MS 38866-7947

Mailing address

1120 County Road 135 E
New Albany, MS 38652-9657
Phone (662) 538-9837

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060823000657 MS Practitioner - Optometry 5496758898 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

109 State Hwy 15 S
New Albany, MS 38652-5206
Phone (662) 534-9288

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
661MSMDChiropractor
2280TNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Vision Services LLC Optometrist CurrentSince Sep 3, 2025 Accepting new patients
Joshua E. Bostick, O.D., P.a. Optometrist Past Accepting new patients
Julie C. Brock, O.D., Inc. Optometrist PastSince Jun 1, 2006 Accepting new patients
Steve Edwards Optometrist Past Accepting new patients
R H Bostwick III OD PastSince Apr 11, 2016 Accepting new patients

Locations

837 Kings Crossing Dr
Ste 10
Tupelo, MS 38804
Phone (662) 269-4175

Interoperability endpoints

  • Direct secure messaging: julie.brock@uprisedirect.com

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, 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": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1720053952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 COUNTY ROAD 135 E",
            "city": "NEW ALBANY",
            "state": "MS",
            "postal_code": "386529657",
            "telephone_number": "662-538-9837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107A TOWN CREEK DR",
            "city": "SALTILLO",
            "state": "MS",
            "postal_code": "388667947",
            "telephone_number": "662-869-1779",
            "fax_number": "662-869-3776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "JULIE",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-21",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "661",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "2280",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saltillo, MS

Sources for this page

Verify at the official NPI Registry.