Individual provider Active NPI

Brock A Glover

  • Family Nurse Practitioner
  • Tallahassee, FL
National Provider Identifier
1801481205
Registry record updated Mar 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11008476 Issued in FL
Practice address
1300 Miccosukee Rd
Tallahassee, FL 32308-5054
Phone
(850) 431-1155
NPI assigned
Mar 8, 2021
Last updated
Mar 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11008476 FL Primary

Addresses

Primary practice location

1300 Miccosukee Rd
Tallahassee, FL 32308-5054

Mailing address

3501 S Blair Stone Rd Apt 218
Tallahassee, FL 32301-6988
Phone (850) 545-9443

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20210401001187 FL Practitioner - Nurse Practitioner 0446667778 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1401 Centerville Rd
Suite G02
Tallahassee, FL 32308-4638
Phone (850) 877-5183

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11008476FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tallahassee Memorial Healthcare Inc Current Accepting new patients
Tallahassee Memorial Healthcare Inc Current Accepting new patients

Locations

1300 Miccosukee Rd
Tallahassee, FL 32308
Phone (850) 431-1155

1607 Saint James Ct
Ste 1
Tallahassee, FL 32308
Phone (850) 431-7021

Interoperability endpoints

  • Direct secure messaging: bglover21865@tallahasseememorial.direct-ci.com
  • Direct secure messaging: brockglover@tmhpp.allscriptsdirect.net

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1615161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1801481205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 S BLAIR STONE RD APT 218",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323016988",
            "telephone_number": "850-545-9443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MICCOSUKEE RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085054",
            "telephone_number": "850-431-1155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOVER",
        "first_name": "BROCK",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-08",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11008476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.