Individual provider Active NPI

Jennifer McBreairty, APRN

  • Family Nurse Practitioner
  • Cape Coral, FL
National Provider Identifier
1083965354
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN3307732 Issued in FL
Practice address
1708 Cape Coral Pkwy W Ste 2
Cape Coral, FL 33914-6985
Phone
(239) 945-5940
Fax
(239) 945-5941
NPI assigned
Sep 27, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN3307732 FL Primary

Addresses

Primary practice location

1708 Cape Coral Pkwy W Ste 2
Cape Coral, FL 33914-6985

Mailing address

12730 New Brittany Blvd Ste 602
Fort Myers, FL 33907-4690
Phone (239) 275-5522

Other identifiers 2

IdentifierTypeStateIssuer
Y0CR6OtherFLFLORIDA BLUE
GN294YOtherFLMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121003000605 FL Practitioner - Nurse Practitioner 1557510757 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

1499 S Brandywine Cir
Fort Myers, FL 33919-6775
Phone (239) 202-0059

1708 Cape Coral Pkwy W
Suite 2
Cape Coral, FL 33914-6985
Phone (239) 945-5940

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN3307732FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Primary Care of Southwest Florida PL CurrentSince Feb 15, 2016 Accepting new patients

Locations

1265 Viscaya Pkwy
Cape Coral, FL 33990
Phone (239) 573-7337

1255 Viscaya Pkwy
Ste 200
Cape Coral, FL 33990
Phone (239) 574-1988

1708 Cape Coral Pkwy W
Ste 2
Cape Coral, FL 33914
Phone (239) 333-3333

12730 New Brittany Blvd
Ste 602
Fort Myers, FL 33907
Phone (239) 275-5522

12730 New Brittany Blvd
Ste 200
Fort Myers, FL 33907
Phone (239) 275-5857

Organizations & group practices 1

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

Hospital & facility affiliations 2

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": "1348704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1083965354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12730 NEW BRITTANY BLVD STE 602",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339074690",
            "telephone_number": "239-275-5522",
            "fax_number": "239-275-4464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 CAPE CORAL PKWY W STE 2",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339146985",
            "telephone_number": "239-945-5940",
            "fax_number": "239-945-5941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCBREAIRTY",
        "first_name": "JENNIFER",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-27",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN3307732",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "Y0CR6",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "GN294Y",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

Verify at the official NPI Registry.