Brandon Premier Healthcare PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BRANDON PREMIER HEALTHCARE PA

Practice address

907 N Parsons Ave
Brandon, FL 33510-3107

Phone

(813) 689-8020

Fax

(813) 689-8381

NPI assigned

Jun 7, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Hillary Lissorn Morgan, ARNPNPI 1669589123

Title

President

Phone

(813) 689-8020

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Hillary Lissorn Morgan, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Seffner, FL
  • NPI 1669589123
  Medicare reassignment NPD Authorized official
• Steven Charles Bowman, MD

  • Internal Medicine Physician
  • Clearwater, FL
  • NPI 1013915404
  Medicare reassignment NPD
• Jorge L Perez Polanco, MD

  • Internal Medicine Physician
  • Brandon, FL
  • NPI 1538158761
  Medicare reassignment NPD
• Christopher Fritzpatrick Jones, MD

  • Hospitalist Physician
  • Charleston, WV
  • NPI 1316131253

  FL

  Medicare reassignment

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501200000000",
    "number": "1548463599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 N PARSONS AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335103107",
            "telephone_number": "813-689-8020",
            "fax_number": "813-689-8381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 N PARSONS AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335103107",
            "telephone_number": "813-689-8020",
            "fax_number": "813-689-8381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANDON PREMIER HEALTHCARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-07",
        "last_updated": "2017-07-28",
        "status": "A",
        "authorized_official_last_name": "MORGAN",
        "authorized_official_first_name": "HILLARY",
        "authorized_official_middle_name": "LISSORN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-689-8020",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "2750432",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274805300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandon Modern Dentistry, PA
• Brandon Nephrology PA
• Brandon Oral Surgery and Specialty Center PLLC
• Brandon Pain Medicine, Inc.
• Brandon Plaza Facility LLC
• Brandon Psychiatric Group LLC
• Brandon Psychiatry and Counseling
• Brandon Regional Hospital
• Brandon SLC Opco, LLC
• Brandon Smiles

• Family Medicine Physician in Brandon, FL
• Providers in Brandon, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2017; 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.