Brightside Pediatrics

Primary specialty

Medically Fragile Infants and Children Day CareTaxonomy code 261QM3000X

Legal business name

BRIGHTSIDE PEDIATRICS

Practice address

1764 Tree Blvd Ste 1
Saint Augustine, FL 32084-5723

Phone

(904) 895-7337

Fax

(904) 925-1365

NPI assigned

Sep 20, 2024

Organization subpart

No

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

Authorized official

Name

Jacque Dennie

Title

Owner, Director of Nursing

Phone

(904) 895-7337

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1726790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726790400000",
    "number": "1376360578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1764 TREE BLVD STE 1",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320845723",
            "telephone_number": "904-895-7337",
            "fax_number": "904-925-1365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1764 TREE BLVD STE 1",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320845723",
            "telephone_number": "904-895-7337",
            "fax_number": "904-925-1365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHTSIDE PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-20",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A",
        "authorized_official_last_name": "DENNIE",
        "authorized_official_first_name": "JACQUE",
        "authorized_official_title_or_position": "OWNER, DIRECTOR OF NURSING",
        "authorized_official_telephone_number": "904-895-7337"
    },
    "taxonomies": [
        {
            "code": "261QM3000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medically Fragile Infants and Children Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alayna Miller Brewer, P.T., DPT
• Christina Marie Brewton, OTR/L
• Lisa M Brice, LCSW
• Bridge to Shore Recovery, LLC (The Augustine Recovery Center)
• Bridge to Shore Recovery, LLC (The Augustine Recovery Center)
• Heather Brinker
• Lisa Britt, LMHC
• Lisa Kay Britton-Willette, RN
• Betsy Britton, MA,CCC
• Michele Brockway, MS, OTR/L

• Medically Fragile Infants and Children Day Care in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Medically Fragile Infants and Children Day Care in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; 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.