Individual provider Active NPI

Brian W Fox, PA-C

  • Physician Assistant
  • Naples, FL
National Provider Identifier
1518028513
Registry record updated Jul 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9114682 Issued in FL
Practice address
1201 Piper Blvd Ste 24
Naples, FL 34110-1385
Phone
(239) 260-5307
Fax
(239) 260-5308
NPI assigned
Dec 13, 2006
Last updated
Jul 12, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9114682 FL Primary
Physician Assistant 363A00000X 1835 CO

Addresses

Primary practice location

1201 Piper Blvd Ste 24
Naples, FL 34110-1385

Mailing address

2270 Somerset PL
Naples, FL 34120-2862
Phone (303) 931-7408

Other identifiers 1

IdentifierTypeStateIssuer
35624221MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210803000097 FL Practitioner - Physician Assistant 9638076805 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1835COMDPhysician Assistant
PA9114682FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mycare Clinic CurrentSince Jul 20, 2021 Accepting new patients

Locations

1201 Piper Blvd
Ste 24
Naples, FL 34110
Phone (239) 260-5307

Interoperability endpoints

  • Direct secure messaging: brian.fox.pa-c.1@8065.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/7973/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1518028513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2270 SOMERSET PL",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341202862",
            "telephone_number": "303-931-7408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 PIPER BLVD STE 24",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341101385",
            "telephone_number": "239-260-5307",
            "fax_number": "239-260-5308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX",
        "first_name": "BRIAN",
        "middle_name": "W",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9114682",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "1835",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35624221",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

Verify at the official NPI Registry.