Bruce Stewart West, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME99878 Issued in FL

Practice address

1340 S 18TH St
#203
Fernandina Beach, FL 32034-4799

Phone

(904) 261-7707

Fax

(907) 261-8616

NPI assigned

Mar 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Bruce S. West

  • Primary Care Clinic/Center
  • Fernandina Beach, FL
  • NPI 1477761625
  Authorized official Same address or phone
• Angel Kids PA

  • Primary Care Clinic/Center
  • Jacksonville, FL
  • NPI 1124162854
  NPD (past)

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439769600000",
    "number": "1588632780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 S 18TH ST",
            "address_2": "#203",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320344799",
            "telephone_number": "904-261-7707",
            "fax_number": "907-261-8616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 S 18TH ST",
            "address_2": "#203",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320344799",
            "telephone_number": "904-261-7707",
            "fax_number": "907-261-8616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEST",
        "first_name": "BRUCE",
        "middle_name": "STEWART",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2015-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101042844",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME99878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280146900",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6734952",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Oneida Lee Wands, FNP-BC
• Scott Allen Weeks, PA-C
• Erin Weems, PA-C
• Carol C Weith, D.D.S.
• Mary R Werger
• Eric Wheeler, DPT
• White Glove Transit Inc
• Janet White
• Jessica Nease White, ED.S.
• Lindsey Brooke White

• Pediatrics Physician in Fernandina Beach, FL
• Providers in Fernandina Beach, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2015; 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.