Heather Suzanne Brock, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

003270 Issued in GA

Practice address

100 Saint Clair Pkwy
Saint Simons Island, GA 31522-1007

Phone

(678) 446-7351

NPI assigned

May 8, 2006

Last updated

May 19, 2016By the provider in NPPES

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

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Privia Medical Group of Georgia LLC

  • Internal Medicine Physician
  • Fayetteville, GA
  • NPI 1013313857
  Medicare reassignment
• Privia Medical Group of Georgia LLC

  • Internal Medicine Physician
  • Savannah, GA
  • NPI 1356907273
  NPD
• Aylo Health, LLC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1013018811
  NPD (past)
• Aylo Health, LLC

  • Family Medicine Physician
  • Ellenwood, GA
  • NPI 1447290218
  NPD (past)
• Aylo Health, LLC

  • Family Medicine Physician
  • Locust Grove, GA
  • NPI 1710929914
  NPD (past)
• Aylo Health, LLC

  • Sleep Medicine (Family Medicine) Physician
  • Stockbridge, GA
  • NPI 1922831445
  NPD (past)
• Jafar Tabatabai M.D. P.C.

  • Geriatric Medicine (Family Medicine) Physician
  • Woodstock, GA
  • NPI 1255731741
  NPD (past)
• Paramount Health Group LLC

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1326250317
  NPD (past)

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463616000000",
    "number": "1891744827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SAINT CLAIR PKWY",
            "city": "SAINT SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315221007",
            "telephone_number": "678-446-7351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SAINT CLAIR PKWY",
            "city": "SAINT SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315221007",
            "telephone_number": "678-446-7351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "HEATHER",
        "middle_name": "SUZANNE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-08",
        "last_updated": "2016-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "003270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenda B Hollis, LPC, PC
• Laura Ann Brennan
• Mark Thomas Brinson, D.O.M.,A.P.,C.N.M.T.
• Brissey Management Trust (Brissey Chiropractic)
• Rachel Skipper Brissey, D.C.
• Austin Nicholas Brown, DDS
• Joshua D Brown, PHARMD
• Lori Marie Brown
• Jonathan Hunter Browning, DPT
• Robert Eric Bryan, MD

• Medical Physician Assistant in St Simons Island, GA
• Providers in St Simons Island, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.