Brenda Marie Jock Derouin, MA, CAS

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

21638 Reed Rd
Watertown, NY 13601-5048

Phone

(315) 786-0677

Fax

(315) 836-3782

NPI assigned

Sep 12, 2014

Sex

Female

Sole proprietor

No

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

Credentials

Master of Arts

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.

• Building Blocks SLP, OT & PT Family Services, PLLC

  • Early Intervention Provider Agency
  • Watertown, NY
  • NPI 1760635205
  NPD (past)

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

{
    "created_epoch": "1410480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410480000000",
    "number": "1780085472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14702 MILITARY RD",
            "city": "SACKETS HARBOR",
            "state": "NY",
            "postal_code": "136852162",
            "telephone_number": "315-646-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21638 REED RD",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136015048",
            "telephone_number": "315-786-0677",
            "fax_number": "315-836-3782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOCK DEROUIN",
        "first_name": "BRENDA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MA, CAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-12",
        "last_updated": "2014-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey S. Aronowitz, M.D.
• Katelyn Jessmer, LMHC, CASAC
• Chris Anne Jewett, NP
• Timothy M Jewett, PHARM.D
• Jill M Laureano Surber DO PC
• John J Poggi, MD PC
• Grace Johnson
• Heather Johnson, LMT
• Katherine S. Johnson, PA-C
• Robert Joseph Johnson, MD

• Specialist in Watertown, NY
• Providers in Watertown, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2014; 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.