Jessica C Brock, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

4423 Bardstown Rd
Louisville, KY 40218-3235

Phone

(502) 749-7909

NPI assigned

May 28, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY, IN2 enrollments

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 2

Merit-based Incentive Payment System (MIPS)

Final score

78.96 of 100Reported as group

Quality

56.12

Promoting interoperability

100

Improvement activities

40

Cost

73.73

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 and National Provider Directory roles.

• University of Kentucky

  • Diagnostic Radiology Physician
  • Lexington, KY
  • NPI 1770771974
  Medicare reassignment NPD
• Baptist Health Medical Group Inc

  • Urgent Care Clinic/Center
  • Louisville, KY
  • NPI 1508269200

  IN

  Medicare reassignment
• Baptist Health Medical Group Inc

  • Nurse Practitioner
  • Lexington, KY
  • NPI 1518360296
  Medicare reassignment
• University of Louisville Physicians, Inc.

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1366722316
  Medicare reassignment
• Baptist Health Medical Group Inc

  • Nurse Practitioner
  • Nicholasville, KY
  • NPI 1255805586

  Physician Assistant

  NPD
• University of Louisville Physicians, Inc.

  dba ULP Radiological Associates

  • Diagnostic Radiology Physician
  • Louisville, KY
  • NPI 1316294127
  NPD
• University of Louisville Physicians, Inc.

  dba ULP ACB Neurosurgery

  • Neurological Surgery Physician
  • Louisville, KY
  • NPI 1952668998
  NPD

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

{
    "created_epoch": "1275004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1902125024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 909",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402010909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4423 BARDSTOWN RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402183235",
            "telephone_number": "502-749-7909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "JESSICA",
        "middle_name": "C",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-28",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA",
            "identifier": "1089287",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayla Marie Brock-Provencher, CSW
• Angela Christina Brock, LCSW, LMFT. MBA
• Charlotte Brock, COTA/L
• Courtney Lynn Brock, M.S., CCC-SLP
• Jamie Brock
• Laura Rose Brock
• Leslie Brooke Brock, MS OTR/L
• Loriann E Brock, OTR/L
• Lorinda A Brock, RBT
• Madalyn Brock, OTR/L

• Physician Assistant in Louisville, KY
• Providers in Louisville, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.