Anwyn Blythe Brock, PA

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

XXXXXX Issued in NJ

Practice address

1505 W Sherman Ave
Vineland, NJ 08360-7059

Phone

(856) 641-8000

NPI assigned

Aug 10, 2024

Last updated

Aug 10, 2024By 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 NJ

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

State licenses

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.

• South Jersey Health System Emergency Physician Services P a

  • Emergency Medicine Physician
  • Elmer, NJ
  • NPI 1306871314
  Medicare reassignment

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

{
    "created_epoch": "1723248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723248000000",
    "number": "1952132060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 CONSHOHOCKEN AVE APT 312",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191315355",
            "telephone_number": "248-505-0079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 W SHERMAN AVE",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083607059",
            "telephone_number": "856-641-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 Front St",
            "address_purpose": "LOCATION",
            "city": "Elmer",
            "state": "NJ",
            "postal_code": "083182101",
            "country_code": "US",
            "telephone_number": "856-363-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROCK",
        "first_name": "ANWYN",
        "middle_name": "BLYTHE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-10",
        "last_updated": "2024-08-10",
        "certification_date": "2024-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "XXXXXX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Saul Bresalier, D.O.
• Brian Jagirdar DMD,PA (Vineland Dental Arts)
• Bright Side Wellness LLC
• Brianna Brion
• Brendaliz Bristol Martir, DMD
• Margaret Brooks
• Yvonne Brooks, LPN
• Brian Brown, PAC
• Ciara Brown
• Sharon Brown, APN

• Emergency Medicine Physician in Vineland, NJ
• Providers in Vineland, NJ by specialty
• Emergency Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2024; 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.