Individual provider Active NPI

Brandi Loverich Ligon, APRN

  • Gerontology Nurse Practitioner
  • Winter Park, FL
National Provider Identifier
1750846077
Registry record updated Apr 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN11001243 Issued in FL
Practice address
2100 Glenwood Dr
Winter Park, FL 32792-3308
Phone
(407) 821-3566
NPI assigned
Feb 1, 2019
Last updated
Apr 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11001243 FL
Gerontology Nurse Practitioner 363LG0600X APRN11001243 FL Primary

Addresses

Primary practice location

2100 Glenwood Dr
Winter Park, FL 32792-3308

Mailing address

2100 Glenwood Dr
Winter Park, FL 32792-3308

Other identifiers 1

IdentifierTypeStateIssuer
109583100MedicaidFL

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
I20210119001665 FL Practitioner - Nurse Practitioner 2668885302 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

2100 Ocoee Apopka Rd
Apopka, FL 32703-9210

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

601 E Rollins St
Orlando, FL 32803-1248
Phone (407) 303-2570

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11001243FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Nurse Practitioner CurrentSince Feb 13, 2023 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Feb 13, 2023 Accepting new patients
Florida Cancer Specialists & Research Institute, LLC CurrentSince Jan 25, 2021 Accepting new patients

Locations

4371 Veronica S Shoemaker Blvd
Fort Myers, FL 33916
Phone (239) 432-8500

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

2824 Enterprise Rd
Orange City, FL 32763
Phone (386) 774-7411

765 Image Way
Orange City, FL 32763
Phone (386) 774-7411

1970 Golf St
Fl Cancer
Sarasota, FL 34236
Phone (941) 795-3780

2100 Glenwood Dr
Winter Park, FL 32792
Phone (407) 646-7000

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1548979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1750846077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 GLENWOOD DR",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327923308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 GLENWOOD DR",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327923308",
            "telephone_number": "407-821-3566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIGON",
        "first_name": "BRANDI",
        "middle_name": "LOVERICH",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-01",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11001243",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN11001243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109583100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.