Organization Active NPI

Brooks & Pottinger, M.D., P.a.

  • Specialist
  • Deland, FL
National Provider Identifier
1457363160
Registry record updated Sep 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME0026840 Issued in FL
Legal business name
BROOKS & POTTINGER, M.D., P.A.
Practice address
850 W Plymouth Avenue
Deland, FL 32720
Phone
(386) 736-6110
Fax
(386) 736-7998
NPI assigned
Aug 12, 2006
Last updated
Sep 2, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2011

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

Authorized official

Name
Dr. Jeffrey B Brooks, M.D.
Title
President
Phone
(386) 736-6110

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME0026840 FL Primary
Obstetrics & Gynecology Physician 207V00000X ME103639 FL
Advanced Practice Midwife 367A00000X 1053372 FL

Addresses

Primary practice location

850 W Plymouth Avenue
Deland, FL 32720

Mailing address

850 W Plymouth Avenue
Deland, FL 32720
Phone (386) 736-6110

Other identifiers 1

IdentifierTypeStateIssuer
253359600MedicaidFL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314921600000",
    "number": "1457363160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 W PLYMOUTH AVENUE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "32720",
            "telephone_number": "386-736-6110",
            "fax_number": "386-736-7998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 W PLYMOUTH AVENUE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "32720",
            "telephone_number": "386-736-6110",
            "fax_number": "386-736-7998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKS & POTTINGER, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-12",
        "last_updated": "2011-09-02",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-736-6110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0026840",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME103639",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "FL",
            "license": "1053372",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "253359600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Deland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2011; 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.