LYDIA JORDAN BROCK DO
NPI 1689391443
Student in an Organized Health Care Education/Training Program in Ypsilanti, MI

Q: What is Lydia Brock's NPI number?

The NPI number for Lydia Brock is 1689391443. It was assigned to this individual provider in the NPPES registry on October 24, 2022.

Q: What is Lydia Brock's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Lydia Brock was last updated on November 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.

Active since October 24, 2022PECOS Enrolled

200 ARNET ST STE 200, YPSILANTI, MI 48198(580) 475-6385 Get Directions Write a Review

NPPES record last updated: November 20, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 20, 2025, Jul 3, 2024, Jun 11, 2024 and 1 more (4 updates tracked since 2022).

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About Lydia Jordan Brock Do NPPES

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

LYDIA JORDAN BROCK DO (NPI 1689391443) is an individual student in an organized health care education/training program in Ypsilanti, Michigan and active in the NPI registry since October 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1689391443

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameLYDIA JORDAN BROCKCredential: DO

Location Address200 ARNET ST STE 200Ypsilanti, MI 48198-5753

Mailing Address200 Arnet St Ste 200Ypsilanti, MI 48198-5753

Phone(580) 475-6385

Sole ProprietorNo

Enumeration DateOctober 24, 2022

Last NPPES UpdateNovember 20, 20254 updates tracked since enumeration

NPPES CertifiedNovember 20, 2025

✔ NPI 1689391443 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.

200 ARNET ST STE 200, Ypsilanti, MI 48198

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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)

Lydia Jordan Brock 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 19

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

LIA ANNA MARINA BOYLE MD, PHD

Pediatrics