Active NPI
Bryna Gordon
- Body Imaging Physician
- Key West, FL
National Provider Identifier
1578827119
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Body Imaging Physician
- License
- 000000000
- Practice address
- 540 Truman Ave
Key West, FL 33040-3141 - Phone
- (305) 296-4399
- Fax
- (305) 294-8270
- NPI assigned
- Jun 28, 2012
- Last updated
- Jun 28, 2012
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Body Imaging Physician | 2085B0100X | 000000000 | FL | Primary |
Addresses
Primary practice location
540 Truman Ave
Key West, FL 33040-3141
Mailing address
540 Truman Ave
Key West, FL 33040-3141
Phone (305) 296-4399
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000000000 | FL | MD | Integrative Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340841600000",
"number": "1578827119",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "540 TRUMAN AVE",
"city": "KEY WEST",
"state": "FL",
"postal_code": "330403141",
"telephone_number": "305-296-4399",
"fax_number": "305-294-8270"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "540 TRUMAN AVE",
"city": "KEY WEST",
"state": "FL",
"postal_code": "330403141",
"telephone_number": "305-296-4399",
"fax_number": "305-294-8270"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "BRYNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-06-28",
"last_updated": "2012-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "2085B0100X",
"taxonomy_group": "",
"desc": "Radiology, Body Imaging",
"state": "FL",
"license": "000000000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Key West, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.