Susan M Brock (NPI# 1730500430, PAC ID# 2860622446) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1730500430 |
| PAC ID by PECOS | 2860622446 |
| Professional Enrollment ID | I20140226002084 |
| Full Name | Susan M Brock |
| Organization Legal Name | LIFE LINE COMMUNITY HEALTHCARE |
| Address |
1657 Commerce Dr Suite 9b South Bend IN 46628-1593 |
| Phone Number | 8669643285 |
| Gender | F |
| Graduation Year | 2013 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 7416170501 |
| Number of Group Practice Members | 60 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 440065 | NORTHCREST MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1616 Westgate Cir, Suite 317, Brentwood, TN 37027-8571 | 8669643285 | LIFE LINE COMMUNITY HEALTHCARE |
| 9850 Von Allmen Ct, Suite 201, Louisville, KY 40241-2855 | 8669643285 | LIFE LINE COMMUNITY HEALTHCARE |
| 1657 Commerce Dr, Suite 9b, South Bend, IN 46628-1593 | 8669643285 | LIFE LINE COMMUNITY HEALTHCARE |
| Organization Legal Name | LIFE LINE COMMUNITY HEALTHCARE |
| Physicians | 95 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ciara L Eatmon | Nurse Practitioner | Life Line Community Healthcare | 625 Kenmoor Ave Se, Suite 301, Grand Rapids, MI 49546-2395 |
| Sharon Lee Morris | Nurse Practitioner | Life Line Community Healthcare | 309 Court Ave, Suite 816, Des Moines, IA 50309-2282 |
| Laura Ann Rogers | Nurse Practitioner | Life Line Community Healthcare | 400 Chesterfield Ctr, Suite 400, Chesterfield, MO 63017-4800 |
| Marian Anne Ferguson | Nurse Practitioner | Life Line Community Healthcare | 1518 Willow Lawn Dr, Richmond, VA 23230-3419 |
| Wendy Ann Lunny | Nurse Practitioner | Life Line Community Healthcare | 615 W Johnson Ave, Cheshire, CT 06410-4532 |
| Laurie Eastwood Raher | Nurse Practitioner | Life Line Community Healthcare | 7455 Arroyo Crossing Pkwy, Suite 220, Las Vegas, NV 89113-4088 |
| Grace D Ortega-walker | Nurse Practitioner | Life Line Community Healthcare | 109 E 17th St, Suite 4984, Cheyenne, WY 82001-4543 |
| Deirdre Lott | Nurse Practitioner | Life Line Community Healthcare | 406 S Boulder Ave, Suite 400, Tulsa, OK 74103-3800 |
| Shimmy Manoj | Nurse Practitioner | Life Line Community Healthcare | 1655 S Blue Island Ave, Suite 361, Chicago, IL 60608-2133 |
| Bryn Miller | Nurse Practitioner | Life Line Community Healthcare | 6111 Oak Tree Blvd, Suite 301, Independence, OH 44131-2589 |
| Street Address |
1657 COMMERCE DR SUITE 9B |
| City | SOUTH BEND |
| State | IN |
| Zip | 46628-1593 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Gretchen Jarrett | Nurse Practitioner | Life Line Community Healthcare | 1657 Commerce Dr, Suite 9b, South Bend, IN 46628-1593 |
| Flora Mashibe | Nurse Practitioner | Life Line Community Healthcare | 1657 Commerce Dr, Suite 9b, South Bend, IN 46628-1593 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kevin W Kaurich | Chiropractic | 21421 Cleveland Rd, South Bend, IN 46628-3507 | |
| John A Whitney | Family Medicine | Beacon Medical Group Inc | 2235 Cleveland Rd, South Bend, IN 46628-3529 |
| Travis W Casper | Family Medicine | Beacon Medical Group Inc | 2235 Cleveland Rd, South Bend, IN 46628-3529 |
| Adeela Alizai | Ophthalmology | 2235 Cleveland Rd, South Bend, IN 46628-3529 | |
| Arif Goreja | Nephrology | Beacon Medical Group Inc | 2235 Cleveland Rd, South Bend, IN 46628-3529 |
| Leah D Craft | Family Medicine | Beacon Medical Group Inc | 2235 Cleveland Rd, South Bend, IN 46628-3529 |
| Syed Mohsan Rizvi | Nephrology | Beacon Medical Group Inc | 2235 Cleveland Rd, South Bend, IN 46628-3529 |
| Charles F Hagenow | Family Medicine | Beacon Medical Group Inc | 2235 Cleveland Rd, South Bend, IN 46628-3529 |
| Christopher Charles Hall | Family Medicine | Beacon Medical Group Inc | 2235 Cleveland Rd, South Bend, IN 46628-3529 |
| Sandra A Cho | Podiatry | Beacon Medical Group Inc | 2235 Cleveland Rd, South Bend, IN 46628-3529 |
| Find all physicians in zip 46628 | |||
| City | SOUTH BEND |
| Zip Code | 46628 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | SOUTH BEND + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Susan M Brock.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.