Heather Ellison Brock, ANP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

751 Issued in AK

Practice address

3760 Piper St Ste 1108
Anchorage, AK 99508-4683

Phone

(907) 212-6900

Fax

(907) 212-6936

NPI assigned

Aug 1, 2006

Last updated

Feb 22, 2024By the provider in NPPES

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AK

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

Specialty

Nurse Practitioner

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Heather Brock, Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • Wasilla, AK
  • NPI 1538359310
  Medicare reassignment NPD
• Providence Health & Services - Washington

  dba Providence Medical Group Alaska

  • Psychiatry Physician
  • Anchorage, AK
  • NPI 1538254347
  Medicare reassignment NPD
• Ptarmigan Psychiatry, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Wasilla, AK
  • NPI 1508612771
  NPD Authorized official
• Providence Health & Services- Washington

  dba Providence Medical Group Alaska

  • Critical Care Medicine (Internal Medicine) Physician
  • Anchorage, AK
  • NPI 1093956278
  NPD (past)

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1992712442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4105",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084105",
            "telephone_number": "866-907-1068",
            "fax_number": "425-917-9141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3760 PIPER ST STE 1108",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084683",
            "telephone_number": "907-212-6900",
            "fax_number": "907-212-6936"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "851 E. Westpoint Dr",
            "address_2": "Ste 208",
            "address_purpose": "LOCATION",
            "city": "Wasilla",
            "state": "AK",
            "postal_code": "996547183",
            "country_code": "US",
            "telephone_number": "907-373-5015",
            "fax_number": "907-373-7015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROCK",
        "first_name": "HEATHER",
        "middle_name": "ELLISON",
        "credential": "ANP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AK",
            "license": "751",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AK",
            "license": "751",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023124",
            "state": "AK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hbrock10239@ak.providencedirect.org",
            "affiliation": "N",
            "address_1": "3260 Providence Dr Ste C537",
            "city": "Anchorage",
            "state": "AK",
            "country_code": "US",
            "postal_code": "995084661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jeremiah Lee Britton, MS RD CDCES BC-ADM
• Olivia Britton, RD
• Russell Lee Britton
• Bradley Brock
• David H Brock, PHD
• Jasmine Brock, MD
• Kymberli Raye Brock, NP-C
• Stuart Brock
• Kristi Brockman
• Richard E Brodsky, MD

• Nurse Practitioner in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Nurse Practitioner in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.
• 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.