Dereni Blake Brock, PT
NPI 1114358702ActiveIndividual· Physical Therapist· London, KY
Physical Therapist (PT) in London, Kentucky, trained at University of Kentucky College of Medicine (class of 2013). Medicare paid $52,056 for services to 100 patients in 2024.
Overview
| NPI | 1114358702 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PT |
| Sole proprietor | Yes |
| NPI issued | Dec 6, 2013 |
| Last updated in NPPES | Oct 28, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 006310 | KY |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physical Therapist in Private Practice (KY) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 100 |
|---|---|
| Services billed | 2,690 across 12 procedure codes |
| Paid by Medicare | $52,056 |
Education and affiliations
| Medical school | University of Kentucky College of Medicine |
|---|---|
| Graduation year | 2013 |
| Medicare specialty | Physical Therapist In Private Practice |
Medical group
- Revolution Physical TherapyLondon, KY · 4 clinicians
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