Active NPI
Bryan Belk
- Nurse's Aide
- Mount Dora, FL
National Provider Identifier
1013361401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- License
- CNA239175
- Practice address
- 17 E Main St
Mount Dora, FL 32757-3470 - Phone
- (352) 735-6034
- NPI assigned
- Apr 21, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | CNA239175 | FL | Primary |
Addresses
Primary practice location
17 E Main St
Mount Dora, FL 32757-3470
Mailing address
17 E Main St
Mount Dora, FL 32757-3470
Phone (352) 735-6034
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9508310839 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CNA239175 | FL | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461196800000",
"number": "1013361401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 E MAIN ST",
"city": "MOUNT DORA",
"state": "FL",
"postal_code": "327573470",
"telephone_number": "352-735-6034"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 E MAIN ST",
"city": "MOUNT DORA",
"state": "FL",
"postal_code": "327573470",
"telephone_number": "352-735-6034"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BELK",
"first_name": "BRYAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-04-21",
"last_updated": "2016-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "FL",
"license": "CNA239175",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9508310839",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mount Dora, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.