Individual provider Active NPI

Brian Medlin, DO

  • Psychiatry Physician
  • Fort Myers, FL
National Provider Identifier
1184120610
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
OS15183 Issued in FL
Practice address
12550 New Brittany Blvd Ste 100
Fort Myers, FL 33907-3655
Phone
(239) 343-9180
NPI assigned
Apr 3, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X OS15183 FL
Psychiatry Physician 2084P0800X OS15183 FL Primary

Addresses

Primary practice location

12550 New Brittany Blvd Ste 100
Fort Myers, FL 33907-3655

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-9180

Other practice location 1

7000 H C Kelley Rd
Orlando, FL 32831-2518
Phone (407) 207-7777

Other identifiers 1

IdentifierTypeStateIssuer
121353500MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bmedlin719730@Direct.leememorial.org Direct LEE HEALTH SYSTEM INC

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
I20200707002605 FL Practitioner - Psychiatry 5395168538 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS15183FLMDAddiction Medicine (Psychiatry & Neurology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virtual Inpatient Psychiatry Physicians Behavioral Network LLC Psychiatry CurrentSince Jul 29, 2020 Accepting new patients
Contemporary Health Services, LLC Psychiatry PastSince May 9, 2021 Accepting new patients

Locations

425 W Colonial Dr
Ste 302
Orlando, FL 32804
Phone (330) 414-9233

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.

NPI Registry JSON

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

{
    "created_epoch": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1184120610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-9180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12550 NEW BRITTANY BLVD STE 100",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073655",
            "telephone_number": "239-343-9180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7000 H C Kelley Rd",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328312518",
            "country_code": "US",
            "telephone_number": "407-207-7777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDLIN",
        "first_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-03",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "FL",
            "license": "OS15183",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "OS15183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121353500",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bmedlin719730@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "LEE HEALTH SYSTEM INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2776 Cleveland Ave",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339015864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.