Alan Clayton Brockhurst, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

ME115271 Issued in FL

Practice address

720 W Oak St
Ste. 101
Kissimmee, FL 34741-4989

Phone

(407) 846-3166

NPI assigned

May 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• West Florida Trauma Network, LLC

  • Trauma Surgery Physician
  • Bradenton, FL
  • NPI 1902198948
  NPD (past)
• Oakwood Group IX, LLC

  • Internal Medicine Physician
  • Dearborn, MI
  • NPI 1720050917

  Surgery

  NPD (past)

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366243200000",
    "number": "1366493892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 W OAK ST",
            "address_2": "STE. 101",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414989",
            "telephone_number": "407-846-3166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 W OAK ST",
            "address_2": "STE. 101",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414989",
            "telephone_number": "407-846-3166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKHURST",
        "first_name": "ALAN",
        "middle_name": "CLAYTON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2013-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME115271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM GROUP",
            "identifier": "C86007",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00374266",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4881673-10",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Brito, B.S.
• Irlande Joseph Britus, ARNP
• Christopher J Broadnax
• Javier Broche
• Mailen Broche, APRN
• Rebecca Fite Brooks, MPH, RD, LDN, CSR
• Ronesha D Brooks, CNA
• Neiraliz Brown Rivera
• Adams Jeremiah Brown, LMT
• Alexandra Brown, ATC, LAT

• Surgery Physician in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2013; 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.