Individual provider Active NPI

Bernard Noble, MD

  • Emergency Medicine Physician
  • Rockledge, FL
National Provider Identifier
1821090143
Registry record updated Apr 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME38622 Issued in FL
Practice address
110 Longwood Ave
Rockledge, FL 32955-2828
Phone
(800) 476-8646
Fax
(919) 382-3210
NPI assigned
Jun 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME38622 FL Primary

Addresses

Primary practice location

110 Longwood Ave
Rockledge, FL 32955-2828

Mailing address

PO Box 30731
Tampa, FL 33630-3731
Phone (800) 476-8646

Other identifiers 1

IdentifierTypeStateIssuer
53675OtherFLBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040128000394 FL Practitioner - Emergency Medicine 1355244419 Reassigns benefits to 1 organization
I20141222002278 KY Practitioner - Emergency Medicine 1355244419 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Dec 1, 2014 Accepting new patients
Sterling Emergency Services of Florida PA Emergency Medicine CurrentSince Mar 1, 2009 Accepting new patients
Sterling Emergency Services of Florida PA Emergency Medicine Current Accepting new patients
Sterling Emergency Services of Florida PA Emergency Medicine CurrentSince Mar 1, 2009 Accepting new patients
Wuesthoff Emergency Physicians PA Emergency Medicine Past Accepting new patients
East Florida Emergency Physician Group LLC Emergency Medicine Past Accepting new patients

Locations

2815 S Seacrest Blvd
Boynton Beach, FL 33435
Phone (561) 732-1277

901 45th St
Mangonia Park, FL 33407
Phone (561) 844-6300

1 Trillium Way
Corbin, KY 40701
Phone (606) 523-8521

Organizations & group practices 6

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": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208476800000",
    "number": "1821090143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30731",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336303731",
            "telephone_number": "800-476-8646",
            "fax_number": "919-382-3210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 LONGWOOD AVE",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329552828",
            "telephone_number": "800-476-8646",
            "fax_number": "919-382-3210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOBLE",
        "first_name": "BERNARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2008-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME38622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "53675",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockledge, FL

Sources for this page

Verify at the official NPI Registry.