Active NPI
Carol J Josephs, RN
- Developmental Disabilities Clinic/Center
- Brandon, FL
National Provider Identifier
1114409091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Disabilities Clinic/Center
- License
- 678549296
- Practice address
- 815 Bryan Rd
Brandon, FL 33511-6132 - Phone
- (813) 810-6257
- Fax
- (866) 666-2451
- NPI assigned
- Sep 6, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Developmental Disabilities Clinic/Center | 261QD1600X | 678549296 | FL | Primary |
Addresses
Primary practice location
815 Bryan Rd
Brandon, FL 33511-6132
Mailing address
815 Bryan Rd
Brandon, FL 33511-6132
Phone (813) 810-6257
Other practice location 1
821 Bryan Rd
Brandon, FL 33511-6132
Phone (813) 810-6257
Other practice location 2
919 Ridgeland Ln
Valrico, FL 33594-4242
Phone (813) 810-6257
Other practice location 3
804 W Bloomingdale Ave
Brandon, FL 33511-7778
Phone (813) 810-6257
Other practice location 4
2640 Ridgetop Way
Valrico, FL 33594-4225
Phone (813) 810-6257
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 678549296 | FL | MD | Developmental Disabilities Clinic/Center |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536192000000",
"number": "1114409091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "815 BRYAN RD",
"city": "BRANDON",
"state": "FL",
"postal_code": "335116132",
"telephone_number": "813-810-6257",
"fax_number": "866-666-2451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "815 BRYAN RD",
"city": "BRANDON",
"state": "FL",
"postal_code": "335116132",
"telephone_number": "813-810-6257",
"fax_number": "866-666-2451"
}
],
"practiceLocations": [
{
"address_1": "821 Bryan Rd",
"address_purpose": "LOCATION",
"city": "Brandon",
"state": "FL",
"postal_code": "335116132",
"country_code": "US",
"telephone_number": "813-810-6257",
"fax_number": "866-666-2451",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "919 Ridgeland Ln",
"address_purpose": "LOCATION",
"city": "Valrico",
"state": "FL",
"postal_code": "335944242",
"country_code": "US",
"telephone_number": "813-810-6257",
"fax_number": "866-666-2451",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "804 W Bloomingdale Ave",
"address_purpose": "LOCATION",
"city": "Brandon",
"state": "FL",
"postal_code": "335117778",
"country_code": "US",
"telephone_number": "813-810-6257",
"fax_number": "866-666-2451",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2640 Ridgetop Way",
"address_purpose": "LOCATION",
"city": "Valrico",
"state": "FL",
"postal_code": "335944225",
"country_code": "US",
"telephone_number": "813-810-6257",
"fax_number": "866-666-2451",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOSEPHS",
"first_name": "CAROL",
"middle_name": "J",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-09-06",
"last_updated": "2018-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "261QD1600X",
"taxonomy_group": "",
"desc": "Clinic/Center, Developmental Disabilities",
"state": "FL",
"license": "678549296",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brandon, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.