Sherry Brock, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

043006 Issued in GA

Practice address

743 Spring St NE
Gainesville, GA 30501-3715

Phone

(770) 536-2146

Fax

(770) 536-7895

NPI assigned

Feb 13, 2006

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

Other identifiers 2

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

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.

• Northside Emergency Associates, LLC

  • Emergency Medicine Physician
  • Sandy Springs, GA
  • NPI 1285686303
  Medicare reassignment NPD
• Emergency Professionals Atlanta, PC

  • Emergency Medicine Physician
  • Atlanta, GA
  • NPI 1578761904
  NPD (past)
• Hartwell Emergency Services, LLC

  • Nurse Practitioner
  • Hartwell, GA
  • NPI 1245272954

  Emergency Medicine

  NPD (past)

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229904000000",
    "number": "1992778591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2938",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305032938",
            "telephone_number": "770-536-2146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 SPRING ST NE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013715",
            "telephone_number": "770-536-2146",
            "fax_number": "770-536-7895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "SHERRY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-13",
        "last_updated": "2008-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "043006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000751572P",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000751572Q",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas Todd Britt, DMD
• Sherry Diane Broadwell, PHD
• Brandy Lynn Brock, LPC
• Deborah Brock, CADC-II
• Ronald Leroy Brock, M.D.
• Timothy Craig Brock, M.D.
• Warner Brock, P.T.,CMDT, MBA, CEAS
• Michelle Marie Brooks, MD
• Rachael Leah Brooks, PA
• Joshua Adam Brotheim, COTA

• Emergency Medicine Physician in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Emergency Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2008; 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.