Rachel Lynn Brock-Childress

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3012818 Issued in KY

Practice address

81 Ball Park Rd
Harlan, KY 40831-1701

Phone

(606) 573-8100

NPI assigned

Apr 25, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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

Nurse Practitioner

State licenses

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.

• Pine Mountain Emergency Group Limited Liability Company

  • Emergency Medicine Physician
  • Harlan, KY
  • NPI 1568010064

  Nurse Practitioner

  Medicare reassignment NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  KY, Nurse Practitioner

  Medicare reassignment NPD

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

{
    "created_epoch": "1524614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541635200000",
    "number": "1972091981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 COUNTY PIKE",
            "city": "HARLAN",
            "state": "KY",
            "postal_code": "408317023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 BALL PARK RD",
            "city": "HARLAN",
            "state": "KY",
            "postal_code": "408311701",
            "telephone_number": "606-573-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK-CHILDRESS",
        "first_name": "RACHEL",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-25",
        "last_updated": "2018-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3012818",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3012818",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1118656",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon Blair, NP
• Marye Margaret Campbell Boggs, MD,MPH
• William Bowling
• Misty Brashears, CRNA
• Kristi Brigmon, MA, CCC-SLP
• Elizabeth Bryson, OTR/L
• Stephen C Bryson, D.M.D.
• Linda Susan Burnett, RPH
• Jameel Butt, MD
• Ashley Leann Caldwell, LPCC

• Family Nurse Practitioner in Harlan, KY
• Providers in Harlan, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2018; 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.