Individual provider Active NPI

Robert B Pierce, CNM

  • Nurse Practitioner
  • Merritt Island, FL
National Provider Identifier
1275627424
Registry record updated Jul 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP1375252 Issued in FL
Practice address
2575 N Courtenay Pkwy
Merritt Island, FL 32953-4126
Phone
(321) 454-7155
Fax
(321) 454-7129
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP1375252 FL Primary

Addresses

Primary practice location

2575 N Courtenay Pkwy
Merritt Island, FL 32953-4126

Mailing address

2575 N Courtenay Pkwy
Merritt Island, FL 32953
Phone (321) 639-5787

Other identifiers 1

IdentifierTypeStateIssuer
034124000MedicaidFL

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050916000260 FL Practitioner - Nurse Practitioner 7810920188 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Department of Health CurrentSince Nov 1, 2015 Accepting new patients
Florida Department of Health CurrentSince Nov 1, 2015 Accepting new patients

Locations

2575 N Courtenay Pkwy
Merritt Island, FL 32953
Phone (321) 454-7148

2575 N Courtenay Pkwy
Rm 110
Merritt Island, FL 32953

2555 Judge Fran Jamieson Way
Viera, FL 32940
Phone (321) 615-9337

Organizations & group practices 2

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436486400000",
    "number": "1275627424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2575 N COURTENAY PKWY",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "32953",
            "telephone_number": "321-639-5787",
            "fax_number": "321-639-5762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2575 N COURTENAY PKWY",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329534126",
            "telephone_number": "321-454-7155",
            "fax_number": "321-454-7129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERCE",
        "first_name": "ROBERT",
        "middle_name": "B",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2015-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP1375252",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "034124000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merritt Island, FL

Sources for this page

Verify at the official NPI Registry.