MR. LUTHER GREEN BROCK CFTS CFO NPI 1821145400

NPI Information

NPI: 1821145400
Provider Name: MR. LUTHER GREEN BROCK, CFTS, CFO
Classification: Orthotic Fitter - 225000000X
Entity Type: Individual
Address:
8007 N POINT BLVD
SUITE F
WINSTON SALEM, NC
ZIP 27106
Phone: (336) 896-0408
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MR. Luther Green Brock, CFTS, CFO is an orthotic fitter in Winston Salem, NC. The provider is an individual trained in the management of fitting prefabricated orthoses. MR. Luther Green Brock, CFTS, CFO NPI is 1821145400. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

8007 N POINT BLVD
SUITE F
WINSTON SALEM, NC
ZIP 27106-268
Phone: (336) 896-0408
Fax: (336) 896-0409

The enumeration date for this NPI number is 1/4/2007 and was last updated on 2/12/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	225000000X	Orthotic Fitter		CFO02049		No
2	225000000X	Orthotic Fitter		CFTS0684		Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	7795387	MEDICAID	NORTH CAROLINA
2	7795178	MEDICAID	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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