Brain and Spine Institute for Children LLC

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

Legal business name

BRAIN AND SPINE INSTITUTE FOR CHILDREN LLC

Practice address

25 W Kaley St
Suite 200
Orlando, FL 32806-2939

Phone

(407) 255-2152

Fax

(407) 264-8395

NPI assigned

Mar 12, 2013

Last updated

Jun 9, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Keyne K Johnson, M. D.NPI 1053577015

Title

President/Owner

Phone

(407) 378-5100

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Tax ID family

Basic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Brain and Spine Instate for Children

  dba Basic

  • Preferred Provider Organization
  • Orlando, FL
  • NPI 1104166735
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Keyne K Johnson, MD

  • Neurological Surgery Physician
  • Winter Park, FL
  • NPI 1053577015
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1363046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370736000000",
    "number": "1821339144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 W KALEY ST",
            "address_2": "SUITE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062939",
            "telephone_number": "407-255-2152",
            "fax_number": "407-264-8395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 W KALEY ST",
            "address_2": "SUITE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062939",
            "telephone_number": "407-255-2152",
            "fax_number": "407-264-8395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAIN AND SPINE INSTITUTE FOR CHILDREN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-12",
        "last_updated": "2013-06-09",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KEYNE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "407-378-5100",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Lynn Bragg
• Alkesh P Brahmbhatt, DO
• Yolanda Brailey, M.A., L.M.H.C., NCC
• Brain & Mind Florida LLC
• Brain and Spine Instate for Children (Basic)
• Brain, Spine and Pain Institute of Lake Nona PLLC
• Meredith Brainard, ARNP
• Braincare, LLC
• Brainlogix Lab, LLC (CogniVita Center for Neuropsychology)
• Brian Alexander Braithwaite, M.D.

• Neurological Surgery Physician in Orlando, FL
• Providers in Orlando, FL by specialty
• Neurological Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.