Kenneth Sean Brock

Primary specialty

Home Health AideTaxonomy code 374U00000X

Practice address

1110 Martin Ave
Toledo, OH 43612-1727

Phone

(937) 830-1313

NPI assigned

Oct 19, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Lifecore Health Services LLC

  • Home Health Agency
  • Toledo, OH
  • NPI 1316896939
  NPD Authorized official

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

{
    "created_epoch": "1603065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1760081038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 MARTIN AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436121727",
            "telephone_number": "937-830-1313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 MARTIN AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436121727",
            "telephone_number": "937-830-1313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "KENNETH",
        "middle_name": "SEAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-19",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Verlene Broadnax
• Deja Mornea Brock-Thomas
• Emma Elizabethq Brock, BSW
• Hannah Brock, PA-C
• Kayla Marie Brock
• Lisa Brock
• Vonita Brock, QMHS
• Suzanne Frances Brodbeck, M.D.
• Matthew Brode
• Stephan Broderick

• Home Health Aide in Toledo, OH
• Providers in Toledo, OH by specialty
• Home Health Aide in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; 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.