NPIMap

Organization Active NPI

Briant G. Moyles D.P.M., P.a.

  • Podiatrist
  • Melbourne, FL
National Provider Identifier
1194998286
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
BRIANT G. MOYLES D.P.M., P.A.
Practice address
1310 W Eau Gallie Blvd
Suite E
Melbourne, FL 32935-5300
Phone
(321) 255-3338
Fax
(321) 253-9643
NPI assigned
Apr 9, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

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

Authorized official

Name
Dr. Richard C Wilson, D.P.M., P.A.NPI 1972587350
Title
President
Phone
(321) 255-3338

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X FL Primary

Addresses

Primary practice location

1310 W Eau Gallie Blvd
Suite E
Melbourne, FL 32935-5300

Mailing address

1515 Dr Martin Luther King Jr Blvd
Melbourne, FL 32901-2946
Phone (321) 723-3500

Other identifiers 2

IdentifierTypeStateIssuer
041009800MedicaidFL
72224OtherFLBCBS

Other names 1

  • Melbourne Podiatry Associates Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Carl Ganio DPM3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

211 E New Haven Ave
Melbourne, FL 32901
Phone (321) 255-3338

Practitioners & affiliated clinicians

Practitioners 5

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": "1207699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677110400000",
    "number": "1194998286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 DR MARTIN LUTHER KING JR BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329012946",
            "telephone_number": "321-723-3500",
            "fax_number": "321-723-1945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 W EAU GALLIE BLVD",
            "address_2": "SUITE E",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329355300",
            "telephone_number": "321-255-3338",
            "fax_number": "321-253-9643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIANT G. MOYLES D.P.M., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-09",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-255-3338",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M., P.A."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041009800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "72224",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Melbourne Podiatry Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Melbourne Podiatry Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2023; 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.