Katharine Elizabeth Brock, M.D., M.S.

Primary specialty

Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X

License

76309 Issued in GA

Practice address

1405 Clifton Rd NE
Brumley Bridge Aflac Suite, HSRB W-340B
Atlanta, GA 30322-4532

Phone

(404) 785-4741

Fax

(404) 727-4455

NPI assigned

Mar 30, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Master of Science

State licenses

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.

• Choa Hospital Based, LLC

  • Pediatrics Physician
  • Brookhaven, GA
  • NPI 1457695488
  NPD (past)

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

{
    "created_epoch": "1238371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478131200000",
    "number": "1962644476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 CLIFTON RD NE",
            "address_2": "BRUMLEY BRIDGE AFLAC SUITE, HSRB W-340B",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303224532",
            "telephone_number": "404-785-4741",
            "fax_number": "404-727-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 CLIFTON RD NE",
            "address_2": "BRUMLEY BRIDGE AFLAC SUITE, HSRB W-340B",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303224532",
            "telephone_number": "404-785-4741",
            "fax_number": "404-727-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "KATHARINE",
        "middle_name": "ELIZABETH",
        "credential": "M.D., M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-30",
        "last_updated": "2016-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "GA",
            "license": "76309",
            "primary": true
        },
        {
            "code": "2080H0002X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Hospice and Palliative Medicine",
            "state": "GA",
            "license": "76309",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Broadwater, PA-C
• Kofi Owusu Manu Brobbey
• Robert Brochstein, D.D.S.
• Regina Brock-Huff, OTR
• Kaitlyn Brock, CPNP
• La-Urshalar B Brock, CNM, FNP-BC
• Sheila Elizabeth Brock, OTRL
• Camille Tisha Brockett, NP
• Paul William Brocklebank II
• Laura Brockmann

• Pediatric Hematology & Oncology Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Pediatric Hematology & Oncology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.