Individual provider Active NPI

Stephen David Parks, M.D.

  • Family Medicine Physician
  • Brandon, FL
National Provider Identifier
1255360749
Registry record updated Oct 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME38237 Issued in FL
Practice address
500 Vonderburg Dr
311 West
Brandon, FL 33511-5964
Phone
(813) 654-2445
Fax
(813) 654-9885
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME38237 FL Primary

Addresses

Primary practice location

500 Vonderburg Dr
311 West
Brandon, FL 33511-5964

Mailing address

PO Box 242
Brandon, FL 33509-0242
Phone (813) 654-2445

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
I20111205000361 FL Practitioner - General Practice 9931006459 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Brandon Area Primary Care, PA Family Medicine CurrentSince Oct 21, 1998 Accepting new patients

Locations

500 Vonderburg Dr
Ste 311W
Brandon, FL 33511
Phone (813) 654-2445

Organizations & group practices 1

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317859200000",
    "number": "1255360749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 242",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335090242",
            "telephone_number": "813-654-2445",
            "fax_number": "813-654-9885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 VONDERBURG DR",
            "address_2": "311 WEST",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115964",
            "telephone_number": "813-654-2445",
            "fax_number": "813-654-9885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "STEPHEN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2011-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME38237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.