Jimmy L Middlebrook, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY 9495 Issued in FL

Practice address

819 SW Federal Hwy
Ste 200 B
Stuart, FL 34994-2952

Phone

(561) 531-8356

NPI assigned

Apr 13, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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.

• Cotler Healthcare & Development Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wellington, FL
  • NPI 1225075047
  Medicare reassignment

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

{
    "created_epoch": "1460505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461196800000",
    "number": "1265896476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4193 SW OAKHAVEN LN",
            "city": "PALM CITY",
            "state": "FL",
            "postal_code": "349907737",
            "telephone_number": "561-531-8356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 SW FEDERAL HWY",
            "address_2": "STE 200 B",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942952",
            "telephone_number": "561-531-8356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDDLEBROOK",
        "first_name": "JIMMY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-13",
        "last_updated": "2016-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 9495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele F Libman MD PA
• Michele F. Libman, M.D., P.a.
• Hanne Mickelson
• Harrison Saull Miclea, PHARMD
• Mid Florida Anesthesia Associates, Inc
• Madison Middleton
• Hannah Taylor Midgley, RBT
• Migun of the Treasure Coast L.L.C.
• Gihan Mikhail
• Robert Ernst Milici, FNP-C

• Clinical Psychologist in Stuart, FL
• Providers in Stuart, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.