KELLY BROCK (NPI# 1992100275) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992100275 |
| Entity Type | Individual |
| Full Name | KELLY BROCK |
| Credential | LAT, ATC |
| Practice Address |
567 N 5th St Terre Haute IN 47809-1903 |
| Practice Telephone | 8122372378 |
| Enumeration Date | 2014-10-28 |
| Last Update Date | 2014-10-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
36002335A | IN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992324578 | Kelly Brock | Nutritionist | 1 Ireland Pl, Amityville, NY 11701-2955 | 2020-04-13 |
| 1730531047 | Kelly Brock | Behavioral Analyst | 35 Revere Rd, Queensbury, NY 12804-8044 | 2016-07-11 |
| 1558679837 | Kelly Brock | Pharmacist | 1312 Olwyn Dr, Tustin, CA 92780-3834 | 2010-09-20 |
| 1891971339 | Kelly Brock | Licensed Practical Nurse | 345 Elmwood Ter, Rochester, NY 14620-3707 | 2008-01-15 |
| 1184198871 | Kelly Brock | Occupational Therapist | 6700 France Ave S Ste 300, Edina, MN 55435-1908 | 2019-01-15 |
| 1588185060 | Kelly Brock | Community/Behavioral Health | 470 Main St, Mashpee, MA 02649-2047 | 2017-07-05 |
| 1043663818 | Kelly Brock | Physician Assistant | 2350 N Lake Dr, Suite 206, Milwaukee, WI 53211-4528 | 2016-07-18 |
| 1922438894 | Kelly Brock | Counselor | 77 E Merrimack St, Lowell, MA 01852-1251 | 2013-11-13 |
| 1316001134 | Kelly Koga Brock | Physical Therapist | 270 International Cir # Twon, Physical Therapy, San Jose, CA 95119-1130 | 2006-12-20 |
| Street Address |
567 N 5TH ST |
| City | TERRE HAUTE |
| State | IN |
| Zip Code | 47809-1903 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477705259 | Lynn Rae Kellett | Nurse Practitioner | 567 N 5th St, Terre Haute, IN 47809-1903 | 2008-10-13 |
| 1134697295 | Dylan Shelby Frazier | Specialist/Technologist | 567 N 5th St, Terre Haute, IN 47809-3358 | 2018-11-07 |
| 1114410750 | Justin Michael Applegate | Physical Therapist | 567 N 5th St, Terre Haute, IN 47809 | 2018-06-08 |
| 1629566252 | Samantha M Polson | Specialist/Technologist | 567 N 5th St, Terre Haute, IN 47809-1903 | 2018-04-30 |
| 1205341906 | Lauren Virginia Cox | Specialist/Technologist | 567 N 5th St, Terre Haute, IN 47809-1903 | 2017-12-05 |
| 1174050769 | Brittney Marie Millspaugh Storms | Physical Medicine & Rehabilitation | 567 N 5th St, Terre Haute, IN 47809-1903 | 2017-05-15 |
| 1811421837 | Melissa Ericson | Specialist/Technologist | 567 N 5th St, Terre Haute, IN 47809-1903 | 2017-04-17 |
| 1326588997 | Union Associated Physicians Clinic, LLC | Family Medicine | 567 N 5th St, Terre Haute, IN 47809-1903 | 2017-03-02 |
| 1164973376 | Chelsey Marie Toney | Student in an Organized Health Care Education/Training Program | 567 N 5th St, Terre Haute, IN 47809-1903 | 2016-10-23 |
| 1336592922 | Jamie Nikander | Specialist/Technologist | 567 N 5th St, Terre Haute, IN 47809-1903 | 2016-07-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699291658 | Shunnosuke Hayashi | Specialist/Technologist | 567 N 5th Street, Scwam 257, Terre Haute, IN 47809 | 2017-08-21 |
| 1730502386 | Joseph Rosauer | Specialist/Technologist | 567 N 5th Street, Sycamore Center for Health and Wellness, Terre Haute, IN 47809 | 2014-01-31 |
| 1063612257 | Indiana State University | Clinic/Center | 567 N 5th St., Terre Haute, IN 47809 | 2007-07-25 |
| 1104851831 | Megan Eileen Tucker | Genetic Counselor, MS | 600 Chestnut St., Science 277, Indiana State University, Terre Haute, IN 47809 | 2006-07-11 |
| 1639626732 | Zoe Lindsley | Specialist/Technologist | 168 Lincoln Quads, Terre Haute, IN 47809-0001 | 2016-09-06 |
| 1174889349 | Shanice Johnson | Specialist/Technologist | Wellness and Applied Medicine Rm 201 5th St, Terre Haute, IN 47809-0001 | 2012-04-02 |
| 1164702452 | Janis Leigh | Psychologist | Indiana State University Psycholog Clinic, Root Hall, Terre Haute, IN 47809-0001 | 2011-08-18 |
| 1447566013 | David John Dziedzicki | Specialist/Technologist | Student Services Building Rm 201, Terre Haute, IN 47809-0001 | 2010-08-20 |
| 1487813028 | Mary Catherine Tucker | Counselor | 1511 College of Education, Indiana State University, Terre Haute, IN 47809-0001 | 2008-06-09 |
| 1023298106 | Benjamin Bradford Fraser | Specialist/Technologist | Athletic Training Department C-06, Indiana State University, Terre Haute, IN 47809-0001 | 2007-11-06 |
| Find all providers in zip 47809 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417421793 | Kimberly Ann White | Specialist/Technologist | 605 Oak Dr, Terre Haute, IN 47803-2337 | 2019-01-19 |
| 1104309624 | Jennifer E Meyer | Specialist/Technologist | 868 Champlain Ct Apt M, Terre Haute, IN 47803-4250 | 2018-09-11 |
| 1215435243 | Margaret Kyle | Specialist/Technologist | 6360 E Old Maple Ave, Terre Haute, IN 47803-9524 | 2018-01-24 |
| 1942711270 | Azumi Koyama | Specialist/Technologist | 1435 S Center St, Terre Haute, IN 47802-1121 | 2017-10-13 |
| 1699291658 | Shunnosuke Hayashi | Specialist/Technologist | 567 N 5th Street, Scwam 257, Terre Haute, IN 47809 | 2017-08-21 |
| 1174047880 | Ariane Alisabeth Clarissa Bell | Specialist/Technologist | 1206 S 18th Street, Terre Haute, IN 47803-4780 | 2017-08-03 |
| 1326578931 | Ian Nicholas Bostock | Specialist/Technologist | 1113 North 8th Street, Terre Haute, IN 47807 | 2017-06-15 |
| 1902336936 | Heather Lynn Pilch | Specialist/Technologist | 2225 Stone Creek Ln, Terre Haute, IN 47802-5438 | 2017-06-13 |
| 1568992592 | Jessica L Montoya | Specialist/Technologist | 6538 Allendale Blvd, Terre Haute, IN 47802-4794 | 2017-06-13 |
| 1770012866 | Taylor Rayl Smith | Specialist/Technologist | 1113 N 8th St, Terre Haute, IN 47807-1517 | 2017-06-12 |
| Find all providers in TERRE HAUTE | ||||
| City | TERRE HAUTE |
| Zip Code | 47809 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.