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BROCK JACKSON DAUGHTRY DO
NPI 1083234942
Student in an Organized Health Care Education/Training Program in Birmingham, AL

Active since April 21, 2020PECOS Enrolled
833 PRINCETON AVE SW, BIRMINGHAM, AL 35211(205) 783-3098 Get Directions Write a Review

NPPES record last updated: April 21, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Brock Jackson Daughtry Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BROCK JACKSON DAUGHTRY DO (NPI 1083234942) is an individual student in an organized health care education/training program in Birmingham, Alabama and active in the NPI registry since April 2020. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1083234942
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameBROCK JACKSON DAUGHTRYCredential: DO
Location Address833 PRINCETON AVE SWBirmingham, AL 35211-1323
Mailing Address833 Princeton Ave SwBirmingham, AL 35211-1323 · (205) 783-3098
Phone(205) 783-3098
Sole ProprietorNo
Enumeration DateApril 21, 2020
NPPES CertifiedApril 21, 2020
✔ NPI 1083234942 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
833 PRINCETON AVE SW, Birmingham, AL 35211
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Brock Jackson Daughtry Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. SARAH BRACHER MD
Student in an Organized Health Care Education/Training Program
833 PRINCETON AVE SW
BIRMINGHAM, AL 35211
Jefferson County (205) 783-7663
MORGAN HYDE STEADING CRNP
Nurse Practitioner (Family)
833 PRINCETON AVE SW
BIRMINGHAM, AL 35211
Jefferson County (205) 786-2776
DR. EMILY CAROLINE HOUSTON DO
Student in an Organized Health Care Education/Training Program
833 PRINCETON AVE SW
BIRMINGHAM, AL 35211
Jefferson County (205) 783-7694
KEVIN C. STAUDINGER M.D.
Preventive Medicine (Occupational Medicine)
833 PRINCETON AVE SW, POB II; SUITE 150
BIRMINGHAM, AL 35211
Jefferson County (205) 781-2699
CHRISTOPHER CARLSON CRNP
Nurse Practitioner (Acute Care)
833 PRINCETON AVE SW
BIRMINGHAM, AL 35211
Jefferson County (205) 786-2776
DR. DANIELLE ELMORE DO
Student in an Organized Health Care Education/Training Program
833 PRINCETON AVE SW
BIRMINGHAM, AL 35211
Jefferson County (205) 783-7694
GABRIEL TOULIATOS DO
Student in an Organized Health Care Education/Training Program
833 PRINCETON AVE SW, POB 3, SUITE 200E
BIRMINGHAM, AL 35211
Jefferson County (205) 599-4823
LAUREN BEATTY LONG
Student in an Organized Health Care Education/Training Program
833 PRINCETON AVE SW
BIRMINGHAM, AL 35211
Jefferson County (205) 599-4822

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Brock Daughtry's NPI number?

The NPI number for Brock Daughtry is 1083234942. It was assigned to this individual provider in the NPPES registry on April 21, 2020.

Where is Brock Daughtry located?

Brock Daughtry practices at 833 Princeton Ave SW, Birmingham, AL 35211. The listed phone number is (205) 783-3098.

What is Brock Daughtry's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Brock Daughtry enrolled in Medicare?

Yes. Brock Daughtry is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Brock Daughtry was last updated on April 21, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.