Individual provider Active NPI

Brian Kiekover, M.D.

  • Emergency Medicine Physician
  • Gainesville, FL
National Provider Identifier
1134324056
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
11379 Issued in FL
Practice address
1600 SW Archer Rd
Gainesville, FL 32610-3003
Phone
(352) 265-5911
NPI assigned
Jun 20, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 11379 FL Primary

Addresses

Primary practice location

1600 SW Archer Rd
Gainesville, FL 32610-3003

Mailing address

6515 NW 27TH Ter
Gainesville, FL 32653-1518
Phone (616) 560-3087

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100430000566 FL Practitioner - Emergency Medicine 7911035506 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11379FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Inc Emergency Medicine CurrentSince Dec 17, 2012 Accepting new patients
Emergency Physicians Inc Emergency Medicine CurrentSince Dec 17, 2012 Accepting new patients
Cobblestone Emergency Physicians Emergency Medicine Past Accepting new patients
Augustine Emergency Physicians LLC Emergency Medicine Past Accepting new patients

Locations

1250 S 18th St
Ste 202
Fernandina Beach, FL 32034
Phone (904) 202-2000

1747 Baptist Clay Dr
Ste 250
Fleming Isle, FL 32003
Phone (904) 516-1000

820 Prudential Dr
Ste 713
Jacksonville, FL 32207
Phone (800) 936-5996

400 Health Park Blvd
St Augustine, FL 32086
Phone (904) 819-4300

Interoperability endpoints

  • Direct secure messaging: bkiekover180561@direct.shands.ufl.edu

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.

NPI Registry JSON

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1134324056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6515 NW 27TH TER",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326531518",
            "telephone_number": "616-560-3087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103003",
            "telephone_number": "352-265-5911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIEKOVER",
        "first_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "11379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.