NPIMap

Individual provider Active NPI

Adam A Brunson, M.D.

  • Family Medicine Physician
  • St Petersburg, FL
National Provider Identifier
1023011913
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME80751 Issued in FL
Practice address
12225 28TH St N Ste B
St Petersburg, FL 33716-1860
Phone
(727) 561-4303
Fax
(727) 561-9299
NPI assigned
May 24, 2005
Last updated
Sep 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME80751 FL Primary
Sports Medicine (Family Medicine) Physician 207QS0010X ME980751 FL

Addresses

Primary practice location

12225 28TH St N Ste B
St Petersburg, FL 33716-1860

Mailing address

12225 28TH St N Ste B
St Petersburg, FL 33716-1860
Phone (727) 561-4303

Other identifiers 1

IdentifierTypeStateIssuer
127498200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110927000089 FL Practitioner - Family PracticePractitioner - Sports Medicine 7618949645 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohi West Medical Group LLCGroup PAC ID 2668882507, 200 clinicians

Practice addresses (Care Compare)

601 7TH St S
St Petersburg, FL 33701-4708
Phone (727) 893-6234

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME80751FLMDFamily Medicine Physician
ME980751FLMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carillon Sports and Family Medicine PA Sports Medicine CurrentSince Oct 19, 2002 Accepting new patients
Ohi West Medical Group, LLC CurrentSince Aug 1, 2025 Accepting new patients
Ohi West Medical Group, LLC Family Medicine CurrentSince Aug 1, 2025 Accepting new patients
Bayfront Enterprises Inc Past Accepting new patients

Locations

12225 28th St N
Ste B
St Petersburg, FL 33716
Phone (727) 561-4303

601 7th St S
St Petersburg, FL 33701
Phone (727) 572-0900

701 6th St S
St Petersburg, FL 33701
Phone (727) 450-1144

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1023011913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12225 28TH ST N STE B",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337161860",
            "telephone_number": "727-561-4303",
            "fax_number": "727-561-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12225 28TH ST N STE B",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337161860",
            "telephone_number": "727-561-4303",
            "fax_number": "727-561-9299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNSON",
        "first_name": "ADAM",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME80751",
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "FL",
            "license": "ME980751",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127498200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.