Individual provider Active NPI

Brookes K Pittman, ARNP

  • Family Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1316483357
Registry record updated Jan 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9250651 Issued in FL
Practice address
4372 Southside Blvd
Unit 206
Jacksonville, FL 32216-8501
Phone
(904) 642-7774
NPI assigned
Jan 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9250651 FL Primary

Addresses

Primary practice location

4372 Southside Blvd
Unit 206
Jacksonville, FL 32216-8501

Mailing address

4372 Southside Blvd
Unit 206
Jacksonville, FL 32216-8501
Phone (904) 642-7774

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ARNP9250651FLMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1484438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484438400000",
    "number": "1316483357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4372 SOUTHSIDE BLVD",
            "address_2": "UNIT 206",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168501",
            "telephone_number": "904-642-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4372 SOUTHSIDE BLVD",
            "address_2": "UNIT 206",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168501",
            "telephone_number": "904-642-7774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITTMAN",
        "first_name": "BROOKES",
        "middle_name": "K",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-15",
        "last_updated": "2017-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9250651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2017; 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.