NPIMap

Organization Active NPI

Broward Neurosurgeons LLC

  • Neurological Surgery Physician
  • Plantation, FL
National Provider Identifier
1366499618
Registry record updated Oct 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
BROWARD NEUROSURGEONS LLC
Practice address
8251 W Broward Blvd
Suite 300
Plantation, FL 33324-2703
Phone
(954) 475-9244
Fax
(954) 475-0848
NPI assigned
May 30, 2006
Organization subpart
Yes
Parent organization
BROWARD NEUROSURGEONS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 17, 2017

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

Authorized official

Name
William Tedrick Johnson
Title
Vice President
Phone
(615) 372-3375

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X Primary

Addresses

Primary practice location

8251 W Broward Blvd
Suite 300
Plantation, FL 33324-2703

Mailing address

8251 W Broward Blvd
Suite 300
Plantation, FL 33324-2703
Phone (954) 475-9244

Other identifiers 2

IdentifierTypeStateIssuer
DA0753OtherRAILROAD
34411OtherFLBLUE CROSS/BLUE SHIELD OF

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040922000609 FL Part B Supplier - Clinic/Group Practice 8123096690 Receives reassigned benefits from 25 practitioners
Practice locations: Miami, FL; Plantation, FL; Port Saint Lucie, FL; Port St Lucie, FL; Tamarac, FL; Aventura, FL; Margate, FL; Davie, FL…

National Provider Directory

National Provider Directory
Part of
Broward Neurosurgeons LLC

Locations

7630 SW 34th Mnr
Ste 325
Davie, FL 33328
Phone (954) 475-6850

7630 SW 34th Mnr
Ste 315
Davie, FL 33328

2401 Frist Blvd
Ste 6
Fort Pierce, FL 34950
Phone (772) 241-6720

7867 SW 88th St
Ste 105
Miami, FL 33156
Phone (305) 279-2900

3683 S Miami Ave
Ste 500
Miami, FL 33133
Phone (305) 285-5025

293 NW Peacock Blvd
Ste 201
Port St Lucie, FL 34986
Phone (772) 204-8870

7431 N University Dr
Ste 211B
Tamarac, FL 33321
Phone (954) 597-9901

2 Maryland Farms
Ste 222
Brentwood, TN 37027

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 50

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 50

NPI Registry JSON

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508198400000",
    "number": "1366499618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8251 W BROWARD BLVD",
            "address_2": "SUITE 300",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242703",
            "telephone_number": "954-475-9244",
            "fax_number": "954-475-0848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8251 W BROWARD BLVD",
            "address_2": "SUITE 300",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242703",
            "telephone_number": "954-475-9244",
            "fax_number": "954-475-0848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROWARD NEUROSURGEONS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BROWARD NEUROSURGEONS LLC",
        "enumeration_date": "2006-05-30",
        "last_updated": "2017-10-17",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "TEDRICK",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "615-372-3375"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "DA0753",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD OF",
            "identifier": "34411",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.