CMS-1500 Box 24J / 33a • NPI
1982558276
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
163W00000X
Licensed & Credentialed Registered Nurse
Box 32 Service Location & ZIP+4
60 HEALTH WAY, JASPER, GA, 30143-1912
✓ 9-Digit EDI 837 ZIP+4 (30143-1912)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1982558276 (KATHY BROCK) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1982558276 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | KATHY BROCK |
| Plain-English Specialty | Licensed & Credentialed Registered Nurse NUCC Code: 163W00000X (Registered Nurse) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 60 HEALTH WAY, JASPER, GA, 30143-1912 |
| Practice Telephone / Fax | Tel: (706) 253-2821 |
| Administrative Mailing Address | 106 MISTY VALLEY DR, CANTON, GA, 30114-7732 |
| Enumeration & Last Sync | Enumerated: 2026-02-24 | CMS Record Updated: 2026-02-24 |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (163W00000X)
What Does Taxonomy Code 163W00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 163W00000X translates to:
"Licensed & Credentialed Registered Nurse"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (KATHY BROCK)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
163W00000X — Registered NursePlain English: Licensed & Credentialed Registered Nurse | State: GA | License: RN112045 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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