NPIMap

Organization Active NPI

Richard S Bragg MD PA

  • Primary Care Clinic/Center
  • Lake Mary, FL
National Provider Identifier
1194000554
Registry record updated Oct 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
ME0065139 Issued in FL
Legal business name
RICHARD S BRAGG MD PA
Practice address
580 Rinehart Rd
Suite 110
Lake Mary, FL 32746-1551
Phone
(407) 805-8989
NPI assigned
Oct 18, 2011
Organization subpart
Yes
Parent organization
RICHARD S BRAGG MD PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 18, 2011

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

Authorized official

Name
Richard Bragg, MD
Title
President
Phone
(407) 805-8989

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X ME0065139 FL Primary

Addresses

Primary practice location

580 Rinehart Rd
Suite 110
Lake Mary, FL 32746-1551

Mailing address

580 Rinehart Rd
Suite 110
Lake Mary, FL 32746-1551
Phone (407) 805-8989

National Provider Directory

National Provider Directory
Part of
Richard S Bragg MD PA

Locations

7009 Dr Phillips Blvd
Ste 240
Orlando, FL 32819
Phone (407) 805-8989

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1318896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318896000000",
    "number": "1194000554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 RINEHART RD",
            "address_2": "SUITE 110",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327461551",
            "telephone_number": "407-805-8989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 RINEHART RD",
            "address_2": "SUITE 110",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327461551",
            "telephone_number": "407-805-8989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD S BRAGG MD PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RICHARD S BRAGG MD PA",
        "enumeration_date": "2011-10-18",
        "last_updated": "2011-10-18",
        "status": "A",
        "authorized_official_last_name": "BRAGG",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-805-8989",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "ME0065139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.