Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Dereni Blake Brock, PT

Individual provider Physical Therapist · NPI 1114358702

Mrs. Dereni Blake Brock, PT is a Physical Therapist in Private Practice in London, Kentucky. Graduated from University of Kentucky College of Medicine in 2013, 13 years ago. Practices with Revolution Physical Therapy, a 4-clinician group and accepts Medicare assignment. Licensed in Kentucky.

Years since qualifying
13
Trained at
University of Kentucky College of Medicine
Licensed in
KY
In the registry since
2013
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

195 Commercial Dr Ste 100
London, KY 40744-5234
Phone: (606) 657-2354
Fax: (606) 657-2354
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 006310 (KY)

Record details

NPI number1114358702
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT
Sole proprietorYes
NPI enumeratedDecember 6, 2013
Last updated in NPPESOctober 28, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolUNIVERSITY OF KENTUCKY COLLEGE OF MEDICINE
Graduated 2013 (13 years in practice)
Group practice Revolution Physical Therapy — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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