Individual provider Active NPI

Briannon Bebble, PA-C

  • Physician Assistant
  • Port St Lucie, FL
National Provider Identifier
1326461617
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9107772 Issued in FL
Practice address
2100 SE Hillmoor Dr Ste 101
Port St Lucie, FL 34952-8057
Phone
(561) 303-3011
NPI assigned
Jan 23, 2014
Last updated
Sep 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9107772 FL Primary

Addresses

Primary practice location

2100 SE Hillmoor Dr Ste 101
Port St Lucie, FL 34952-8057

Mailing address

2100 SE Hillmoor Dr Ste 101
Port St Lucie, FL 34952-8057
Phone (561) 303-3011

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
I20140212000416 FL Practitioner - Physician Assistant 3274762307 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Care and Wellness PLLCGroup PAC ID 7618466749, 2 clinicians

Practice addresses (Care Compare)

2100 SE Hillmoor Dr
Suite 101
Port St Lucie, FL 34952-8057
Phone (561) 262-8785

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9107772FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Care and Wellness PLLC Physician Assistant CurrentSince Sep 17, 2025 Accepting new patients

Locations

2100 SE Hillmoor Dr
Ste 101
Port St Lucie, FL 34952
Phone (561) 262-8785

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1390435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1326461617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 SE HILLMOOR DR STE 101",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349528057",
            "telephone_number": "561-303-3011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 SE HILLMOOR DR STE 101",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349528057",
            "telephone_number": "561-303-3011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEBBLE",
        "first_name": "BRIANNON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-23",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9107772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.