Individual provider Active NPI

Justin Mitchell Bremer, D.O.

  • Anesthesiology Physician
  • Gainesville, FL
National Provider Identifier
1093984296
Registry record updated May 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
0102204527 Issued in VA
Practice address
1601 SW Archer Rd
Gainesville, FL 32608-1135
Phone
(352) 376-1611
NPI assigned
Feb 21, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X UO3656 FL
Anesthesiology Physician 207L00000X 0102204527 VA Primary

Addresses

Primary practice location

1601 SW Archer Rd
Gainesville, FL 32608-1135

Mailing address

1601 SW Archer Rd
Gainesville, FL 32608-1135
Phone (352) 376-1611

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200114002742 VA Practitioner - Anesthesiology 0244466225 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Kansas City College of Medicine and Surgery, 2007
Medicare assignment
May accept Medicare assignment
Group practices
Premier Anesthesia of Virginia LLCGroup PAC ID 1951722362, 48 clinicians

Practice addresses (Care Compare)

2204 Wilborn Ave
South Boston, VA 24592-1645
Phone (434) 517-3100

Hospital & facility affiliations

  • Sentara Halifax Regional Hospital Hospital, South Boston, VA, CCN 490013

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0102204527VAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Anesthesia of Virginia LLC Anesthesiology CurrentSince Jan 4, 2022 Accepting new patients

Locations

2204 Wilborn Ave
South Boston, VA 24592
Phone (434) 517-3100

100 Sentara Cir
Williamsburg, VA 23188
Phone (678) 690-7826

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 1

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": "1203552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746748800000",
    "number": "1093984296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326081135",
            "telephone_number": "352-376-1611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326081135",
            "telephone_number": "352-376-1611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREMER",
        "first_name": "JUSTIN",
        "middle_name": "MITCHELL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-21",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "UO3656",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "0102204527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.