Individual provider Active NPI

Patricia June Philbrick, APRN

  • Nurse Practitioner
  • Rockledge, FL
National Provider Identifier
1639717440
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11003909 Issued in FL
Practice address
1950 Rockledge Blvd
Ste 101
Rockledge, FL 32955-3763
Phone
(321) 636-0005
Fax
(321) 265-4061
NPI assigned
Dec 12, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11003909 FL
Nurse Practitioner 363L00000X APRN11003909 FL Primary

Addresses

Primary practice location

1950 Rockledge Blvd
Ste 101
Rockledge, FL 32955-3763

Mailing address

1950 Rockledge Blvd
Ste 101
Rockledge, FL 32955-3763
Phone (321) 636-0005

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
I20200422000796 FL Practitioner - Nurse Practitioner 7810327475 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN11003909FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brevard Family Walk in Clinic LLC CurrentSince Feb 10, 2020 Accepting new patients

Locations

1950 US Highway 1
Ste 101
Rockledge, FL 32955
Phone (321) 636-0005

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1576108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1639717440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 ROCKLEDGE BLVD",
            "address_2": "STE 101",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329553763",
            "telephone_number": "321-636-0005",
            "fax_number": "321-265-4061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 ROCKLEDGE BLVD",
            "address_2": "STE 101",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329553763",
            "telephone_number": "321-636-0005",
            "fax_number": "321-265-4061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILBRICK",
        "first_name": "PATRICIA",
        "middle_name": "JUNE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-12",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11003909",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11003909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockledge, FL

Sources for this page

Verify at the official NPI Registry.