Individual provider Active NPI

Brooke Morgan Lavine

  • Pediatric Nurse Practitioner
  • West Palm Beach, FL
National Provider Identifier
1114741345
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
11035581 Issued in FL
Practice address
500 N Federal Hwy
West Palm Beach, FL 33403-3598
Phone
(407) 898-2767
NPI assigned
Nov 13, 2024
Last updated
Nov 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 11035581 FL Primary

Addresses

Primary practice location

500 N Federal Hwy
West Palm Beach, FL 33403-3598

Mailing address

19643 Rugged Trunk TRL
Loxahatchee, FL 33470-2143
Phone (561) 797-8760

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

LicenseStateTypeSpecialty
11035581FLMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Pediatric Pulmonary and Sleep Associates PA PastSince Nov 17, 2024 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1731456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1114741345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19643 RUGGED TRUNK TRL",
            "city": "LOXAHATCHEE",
            "state": "FL",
            "postal_code": "334702143",
            "telephone_number": "561-797-8760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N FEDERAL HWY",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334033598",
            "telephone_number": "407-898-2767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVINE",
        "first_name": "BROOKE",
        "middle_name": "MORGAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-13",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "11035581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.