Individual provider Active NPI

Brandi Amelia Epperson, APRN, FNP-C

  • Family Nurse Practitioner
  • Orange Park, FL
National Provider Identifier
1154757151
Registry record updated Sep 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11014502 Issued in FL
Practice address
1555 Kingsley Ave Ste 604
Orange Park, FL 32073-9207
Phone
(904) 541-0670
Fax
(904) 541-0680
NPI assigned
Sep 23, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN0000017905 TN
Family Nurse Practitioner 363LF0000X APRN11014502 FL Primary

Addresses

Primary practice location

1555 Kingsley Ave Ste 604
Orange Park, FL 32073-9207

Mailing address

2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342
Phone (877) 856-3774

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210924003002 FL Practitioner - Nurse Practitioner 5799078432 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Wellness Center GCS IncGroup PAC ID 3375885890, 2 clinicians

Practice addresses (Care Compare)

3189 Hwy 17
Green Cove Springs, FL 32043-9371
Phone (904) 621-0247

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11014502FLMDFamily Nurse Practitioner
APN0000017905TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC CurrentSince Sep 20, 2021 Accepting new patients
Millennium Physician Group LLC CurrentSince Sep 20, 2021 Accepting new patients
Family Wellness Center GCS Inc CurrentSince Sep 18, 2023 Accepting new patients

Locations

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

3189 Highway 17
Green Cv Spgs, FL 32043
Phone (904) 284-2828

1555 Kingsley Ave
Ste 604
Orange Park, FL 32073
Phone (904) 541-0670

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JHCJBD
  • FHIR API: https://fhir4.healow.com/fhir/r4/JHCJBD/Endpoint/JHCJBD

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": "1379894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1154757151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 KINGSLEY AVE STE 604",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320739207",
            "telephone_number": "904-541-0670",
            "fax_number": "904-541-0680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EPPERSON",
        "first_name": "BRANDI",
        "middle_name": "AMELIA",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-23",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN0000017905",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11014502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.