Healthcare Provider Details

I. General information

NPI: 1093238016
Provider Name (Legal Business Name): KARA BROCK DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2017
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5653 FRIST BLVD STE 734
HERMITAGE TN
37076-2066
US

IV. Provider business mailing address

5653 FRIST BLVD STE 734
HERMITAGE TN
37076-2066
US

V. Phone/Fax

Practice location:
  • Phone: 615-437-2028
  • Fax: 615-576-2759
Mailing address:
  • Phone: 615-437-2028
  • Fax: 615-576-2759

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number971
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: