DR. KATELYN F BROCK MD
NPI 1366239089
Student in an Organized Health Care Education/Training Program in Jacksonville, FL
About Dr. Katelyn F Brock Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. KATELYN F BROCK MD (NPI 1366239089) is an individual student in an organized health care education/training program in Jacksonville, Florida and active in the NPI registry since April 2025. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Katelyn F Brock Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
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.
JACKSONVILLE, FL 32204
JACKSONVILLE, FL 32204
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 Katelyn Brock's NPI number?
The NPI number for Katelyn Brock is 1366239089. It was assigned to this individual provider in the NPPES registry on April 24, 2025.
Where is Katelyn Brock located?
Katelyn Brock practices at 2627 Riverside Ave, Jacksonville, FL 32204. The listed phone number is (904) 308-7372.
What is Katelyn Brock's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Katelyn Brock enrolled in Medicare?
Yes. Katelyn Brock is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Katelyn Brock was last updated on April 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.
# Dr. Katelyn F Brock, MD · NPI 1366239089
Student in an Organized Health Care Education/Training Program provider in Jacksonville, Florida. Individual provider, active in the CMS NPPES registry since April 24, 2025.
## Identity
- **NPI:** 1366239089 (Entity type: Individual)
- **Enumerated:** April 24, 2025
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** Yes
## Practice location
- **Address:** 2627 RIVERSIDE AVE, Jacksonville, FL 32204-4717
- **Phone:** (904) 308-7372
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** April 24, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1366239089) · Data from the CMS NPPES public registry.