Active NPI
James Michael Brockwell, RD
- Registered Dietitian
- Avon Park, FL
National Provider Identifier
1477060317
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- ND8316
- Practice address
- 1603 N Palm Dr
Avon Park, FL 33825-2127 - Phone
- (863) 873-1988
- NPI assigned
- Dec 31, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | ND8316 | FL | Primary |
Addresses
Primary practice location
1603 N Palm Dr
Avon Park, FL 33825-2127
Mailing address
1603 N Palm Dr
Avon Park, FL 33825-2127
Phone (863) 873-1988
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ND8316 | FL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1514678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1514678400000",
"number": "1477060317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1603 N PALM DR",
"city": "AVON PARK",
"state": "FL",
"postal_code": "338252127",
"telephone_number": "863-873-1988"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1603 N PALM DR",
"city": "AVON PARK",
"state": "FL",
"postal_code": "338252127",
"telephone_number": "863-873-1988"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROCKWELL",
"first_name": "JAMES",
"middle_name": "MICHAEL",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-12-31",
"last_updated": "2017-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "ND8316",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Avon Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.