Individual provider Active NPI

Mitchell Brantley

  • Emergency Medicine Physician
  • Pensacola, FL
National Provider Identifier
1144320540
Registry record updated Feb 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME87928 Issued in FL
Practice address
1000 W Moreno St
Pensacola, FL 32501
Phone
(850) 434-4011
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2008

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 ME87928 FL Primary

Addresses

Primary practice location

1000 W Moreno St
Pensacola, FL 32501

Mailing address

P O Box 409703
Atlanta, GA 30384-7903
Phone (770) 874-5400

Other identifiers 1

IdentifierTypeStateIssuer
267534000MedicaidFL

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
I20111026000525 FL Practitioner - Emergency Medicine 0547333874 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
97.8 of 100Reported as group
Quality
93.19
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME87928FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pensacola Emergency Physicians, LLC Emergency Medicine Current Accepting new patients
Pensacola Emergency Physicians, LLC Emergency Medicine CurrentSince Aug 12, 2003 Accepting new patients
Ohio Emergency Physicians LLC Emergency Medicine Past Accepting new patients

Locations

1000 W Moreno St
Pensacola, FL 32501
Phone (850) 434-4011

123 Baptist Way
Pensacola, FL 32503
Phone (850) 434-4011

1110 Gulf Breeze Pkwy
Pensacola Beach, FL 32561
Phone (850) 438-1848

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202256000000",
    "number": "1144320540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 409703",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303847903",
            "telephone_number": "770-874-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W MORENO ST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "32501",
            "telephone_number": "850-434-4011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANTLEY",
        "first_name": "MITCHELL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2008-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME87928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "267534000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.