1. Home
  2. Directory
  3. Tennessee
  4. Bolivar
  5. Nurse Practitioner
  6. NPI Profile
Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

SAMANTHA ELIZABETH BROCK
NPI 1609601699
Nurse Practitioner - Family in Bolivar, TN

Active since September 07, 2024
629 NUCKOLLS RD, BOLIVAR, TN 38008(731) 658-3388 Get Directions Write a Review

NPPES record last updated: July 24, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 24, 2026, Oct 7, 2024, Sep 7, 2024 (3 updates tracked since 2024).

About Samantha Elizabeth Brock NPPES

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

SAMANTHA ELIZABETH BROCK (NPI 1609601699) is an individual family provider in Bolivar, Tennessee, licensed in Tennessee (42277) and active in the NPI registry since September 2024. She maintains 4 additional practice locations.

NPPES Registry Identity

NPI1609601699
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameSAMANTHA ELIZABETH BROCK
Location Address629 NUCKOLLS RDBolivar, TN 38008-1599
Mailing Address629 Nuckolls RdBolivar, TN 38008-1599 · (731) 658-3388
Phone(731) 658-3388
Sole ProprietorNo
Enumeration DateSeptember 7, 2024
Last NPPES UpdateJuly 24, 20263 updates tracked since enumeration
NPPES CertifiedJuly 24, 2026
✔ NPI 1609601699 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in TN · 42277
629 NUCKOLLS RD, Bolivar, TN 38008
Open in Google Maps ↗

Secondary Practice Locations 4

Location 11132 Industrial DrHenderson, TN 38340-1310 · Phone (731) 983-3175
Location 2627 Nuckolls RoadBolivar, TN 38008 · Phone (731) 600-1063
Location 317 1st St EStanton, TN 38069-4426 · Phone (731) 548-2232
Location 4445 Nuckolls RdBolivar, TN 38008-1539 · Phone (731) 658-2902

Other Providers at the Same Location NPPES 19

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

MS. JEANNIE A FERRI FNP
Nurse Practitioner (Family)
629 NUCKOLLS RD
BOLIVAR, TN 38008
Hardeman County (731) 658-3388
JUDITH ANNE TESSEMA
Family Medicine
629 NUCKOLLS RD
BOLIVAR, TN 38008
Hardeman County (731) 658-3388
ALLISON LEANN ADAMS FNP-C
Nurse Practitioner (Family)
629 NUCKOLLS RD
BOLIVAR, TN 38008
Hardeman County (731) 658-3388
HARDEMAN COUNTY COMMUNITY HEALTH CENTER
Clinic/Center (Community Health)
629 NUCKOLLS RD
BOLIVAR, TN 38008
Hardeman County (731) 658-3388
ERIC ALAN FOLK DPH
Pharmacist
629 NUCKOLLS RD
BOLIVAR, TN 38008
Hardeman County (731) 658-5294
DR. JOHN LEE BLANKENSHIP M.D.
Family Medicine
629 NUCKOLLS RD
BOLIVAR, TN 38008
Hardeman County (731) 658-3388
DR. SAMUEL TERRY JOHNSON JR. M.D.
Family Medicine
629 NUCKOLLS RD
BOLIVAR, TN 38008
Hardeman County (731) 658-3388
LAWRENCE DIAZ D.O.
Family Medicine
629 NUCKOLLS RD
BOLIVAR, TN 38008
Hardeman County (731) 658-3388

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 Samantha Brock's NPI number?

The NPI number for Samantha Brock is 1609601699. It was assigned to this individual provider in the NPPES registry on September 7, 2024.

Where is Samantha Brock located?

Samantha Brock practices at 629 Nuckolls Rd, Bolivar, TN 38008. The listed phone number is (731) 658-3388.

What is Samantha Brock's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Samantha Brock was last updated on July 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 days 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.