Individual provider Active NPI

Mark Douglas Nanni, MD

  • Diagnostic Radiology Physician
  • Brandon, FL
National Provider Identifier
1184620692
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME45556 Issued in FL
Practice address
613 Oakfield Dr
Brandon, FL 33511-5714
Phone
(813) 661-2222
Fax
(813) 681-8494
NPI assigned
Jun 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME45556 FL Primary

Addresses

Primary practice location

613 Oakfield Dr
Brandon, FL 33511-5714

Mailing address

122 Linsley Ave
Ste a
Brandon, FL 33511-5121
Phone (813) 657-4914

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
I20031219000358 FL Practitioner - Diagnostic Radiology 3779481486

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Brandon Imaging LLC Diagnostic Radiology Past Accepting new patients
North Brandon Imaging LLC Diagnostic Radiology Past Accepting new patients
North Tampa Imaging LLC Diagnostic Radiology Past Accepting new patients
Total Imaging-Parsons LLC Diagnostic Radiology Past Accepting new patients
Sun City Imaging LLC Diagnostic Radiology Past Accepting new patients

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 5

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": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1184620692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 LINSLEY AVE",
            "address_2": "STE A",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115121",
            "telephone_number": "813-657-4914",
            "fax_number": "813-657-4916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 OAKFIELD DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115714",
            "telephone_number": "813-661-2222",
            "fax_number": "813-681-8494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANNI",
        "first_name": "MARK",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-21",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME45556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.