Individual provider Active NPI

Brian Michael Winburn

  • Pediatrics Physician
  • Savannah, GA
National Provider Identifier
1710483672
Registry record updated Jan 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
OS17850 Issued in FL
Practice address
4700 Waters Ave
Savannah, GA 31404-6220
Phone
(912) 350-8193
NPI assigned
Mar 31, 2018
Last updated
Jan 12, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Pediatrics Physician 208000000X OS17850 FL Primary
Hospitalist Physician 208M00000X OS17850 FL

Addresses

Primary practice location

4700 Waters Ave
Savannah, GA 31404-6220

Mailing address

301 Memorial Medical Pkwy
Daytona Beach, FL 32117-5167
Phone (407) 975-0410

Other practice location 1

601 E Rollins St
Orlando, FL 32803-1248
Phone (407) 975-0412

Other practice location 2

301 Memorial Medical Pkwy
Daytona Beach, FL 32117-5167
Phone (407) 975-0410

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210804000655 FL Practitioner - Pediatric Medicine 8527462118 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS17850FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Pediatrics CurrentSince Aug 16, 2021 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Aug 16, 2021 Accepting new patients
Phoenix Pediatrics of Broward LLC Pediatrics CurrentSince May 1, 2025 Accepting new patients
Phoenix Pediatrics of Broward LLC Pediatrics CurrentSince May 1, 2025 Accepting new patients

Locations

1600 S Andrews Ave
Ft Lauderdale, FL 33316
Phone (954) 355-4000

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

3000 Coral Hills Dr
Pompano Beach, FL 33065
Phone (954) 344-3000

Interoperability endpoints

  • Direct secure messaging: bwinburn70753@adventhealth.direct-ci.com

Organizations & group practices 4

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": "1522454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1710483672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 MEMORIAL MEDICAL PKWY",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175167",
            "telephone_number": "407-975-0410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 WATERS AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046220",
            "telephone_number": "912-350-8193"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 E Rollins St",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328031248",
            "country_code": "US",
            "telephone_number": "407-975-0412",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 Memorial Medical Pkwy",
            "address_purpose": "LOCATION",
            "city": "Daytona Beach",
            "state": "FL",
            "postal_code": "321175167",
            "country_code": "US",
            "telephone_number": "407-975-0410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WINBURN",
        "first_name": "BRIAN",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-31",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "OS17850",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "OS17850",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.