Individual provider Active NPI

James Thomas Brown Jr., NURSE ANESTHETIST

  • Certified Registered Nurse Anesthetist
  • Port St Lucie, FL
National Provider Identifier
1407894272
Registry record updated Nov 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1447922 Issued in FL
Practice address
880 SW Grand Reserve Blvd
Port St Lucie, FL 34986-2339
Phone
(772) 340-7788
Fax
(772) 343-7419
NPI assigned
Jun 3, 2006
Last updated
Nov 1, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1447922 FL Primary

Addresses

Primary practice location

880 SW Grand Reserve Blvd
Port St Lucie, FL 34986-2339

Mailing address

880 SW Grand Reserve Blvd
Port St Lucie, FL 34986-2339
Phone (772) 340-7788

Other identifiers 1

IdentifierTypeStateIssuer
301032500MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060208000737 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 0547275729 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centurion Anesthesia - FL LLCGroup PAC ID 6103205620, 106 clinicians

Practice addresses (Care Compare)

3800 Johnson St
Suite D
Hollywood, FL 33021-6052
Phone (917) 681-4963

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
1447922FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Lucie Anesthesia Associates, LLC CurrentSince Oct 1, 2024 Accepting new patients
Fpra Anesthesia Services LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 11, 2022 Accepting new patients
National Surgical Centers of America LLC PastSince Mar 11, 2022 Accepting new patients
Atlantic Coast Anesthesia Associates Past Accepting new patients
Phoenix Anesthesia PLLC Past Accepting new patients

Locations

3995 NW Goldenrod Rd
Jensen Beach, FL 34957
Phone (772) 497-0020

150 SW Chamber Ct
Ste 104
Port St Lucie, FL 34986
Phone (772) 879-5300

13945 N US Highway 441
The Villages, FL 32159
Phone (352) 277-3500

3602 Kyoto Gardens Dr
West Palm Beach, FL 33410
Phone (561) 799-2288

1693 Lee Rd
Ste A
Winter Park, FL 32789
Phone (407) 287-4300

Organizations & group practices 7

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": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541030400000",
    "number": "1407894272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 SW GRAND RESERVE BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349862339",
            "telephone_number": "772-340-7788",
            "fax_number": "772-343-7419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 SW GRAND RESERVE BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349862339",
            "telephone_number": "772-340-7788",
            "fax_number": "772-343-7419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JAMES",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "NURSE ANESTHETIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2018-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "1447922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "301032500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.