Charles F. Brinegar Jr., ARNP

Individual provider Active NPI Family Nurse Practitioner · Lecanto, FL

NPI 1174033435 · NPPES record last updated Feb 15, 2018

Key facts

NPI
1174033435
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
ARNP3143482 (FL)
Practice address
1990 N Prospect Ave
Lecanto, FL 34461-9792
Phone
(352) 527-6888
NPI assigned
Oct 1, 2017
Sex
Male
Sole proprietor
No

Organizations & group practices 2

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.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
University of South Florida College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Internal Medicine and Pediatrics Wellness Center (6 clinicians)

Practice addresses (Care Compare)

6038 W Nordling Loop
Crystal River, FL 34429-8715
Phone (352) 563-5070

Medicare participation

Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20180316002057 FL Practitioner - Nurse Practitioner 7517229248 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP3143482FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine & Pediatrics Wellness Center Current
since May 29, 2023
Accepting new patients
Quality Healthcare Services PLLC Current
since Nov 1, 2024
Accepting new patients

Locations

6038 W Nordling Loop
Crystal River, FL 34429
Phone (352) 563-5070

6026 W Nordling Loop
Crystal River, FL 34429
Phone (352) 354-4476

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22703/brand/1/csg/1/fhir/r4

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP3143482 FL Yes

Addresses

Primary practice location

1990 N Prospect Ave
Lecanto, FL 34461-9792

Mailing address

1990 N Prospect Ave
Lecanto, FL 34461-9792
Phone (352) 527-6888

Other providers in Lecanto, FL

All providers in Lecanto, FL · Family Nurse Practitioner in Florida

Sources for this page

Verify at the official NPI Registry.