NPIMap

Organization Active NPI

JBRC Medical, LLC

  • Specialist
  • Jensen Beach, FL
National Provider Identifier
1902144140
Registry record updated Dec 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA 55754 Issued in FL
Legal business name
JBRC MEDICAL, LLC
Practice address
1802 NE Jensen Beach Blvd
Jensen Beach, FL 34957-7234
Phone
(772) 252-1235
Fax
(772) 252-1236
NPI assigned
Jan 23, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2019

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

Authorized official

Name
Christopher Hall
Title
Director of Billing
Phone
(772) 261-3422

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X AP 1330 FL
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X MA 55754 FL Primary
Addiction Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0802X ME61588 FL
Medical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AM0700X PA9104027 FL

Addresses

Primary practice location

1802 NE Jensen Beach Blvd
Jensen Beach, FL 34957-7234

Mailing address

1802 NE Jensen Beach Blvd
Jensen Beach, FL 34957-7234
Phone (772) 252-1235

National Provider Directory

National Provider Directory
Tax ID family
JBRC Medical LLC2 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.

NPI Registry JSON

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

{
    "created_epoch": "1358899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577404800000",
    "number": "1902144140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 NE JENSEN BEACH BLVD",
            "city": "JENSEN BEACH",
            "state": "FL",
            "postal_code": "349577234",
            "telephone_number": "772-252-1235",
            "fax_number": "772-252-1236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 NE JENSEN BEACH BLVD",
            "city": "JENSEN BEACH",
            "state": "FL",
            "postal_code": "349577234",
            "telephone_number": "772-252-1235",
            "fax_number": "772-252-1236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JBRC MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-23",
        "last_updated": "2019-12-27",
        "certification_date": "2019-12-27",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING",
        "authorized_official_telephone_number": "772-261-3422"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "FL",
            "license": "AP 1330",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "MA 55754",
            "primary": true
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "FL",
            "license": "ME61588",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9104027",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jensen Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.