Individual provider Active NPI

Bruce Glenn Rankin, D. O.

  • Family Medicine Physician
  • Deland, FL
National Provider Identifier
1922027853
Registry record updated Apr 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0S6029 Issued in FL
Practice address
999 W Plymouth Ave
Deland, FL 32720-3134
Phone
(386) 740-7080
Fax
(386) 734-0821
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0S6029 FL Primary

Addresses

Primary practice location

999 W Plymouth Ave
Deland, FL 32720-3134

Mailing address

862 Peachwood Dr
Deland, FL 32720-0834
Phone (386) 740-7080

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
I20040510000261 FL Practitioner - Family Practice 0547259137 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0S6029FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ormond Medical Arts Family Practice LLC Family Medicine CurrentSince May 1, 2019 Accepting new patients
Family Practice of West Volusia Inc Past Accepting new patients
Memorial Hospital-West Volusia Inc Past Accepting new patients
Family Practice of West Volusia Inc Past Accepting new patients

Locations

999 W Plymouth Ave
Deland, FL 32720
Phone (386) 740-7080

2582 S Volusia Ave
Orange City, FL 32763
Phone (386) 774-0109

77 W Granada Blvd
Ormond Beach, FL 32174
Phone (386) 677-0453

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1579/brand/8/csg/141/fhir/r4

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554336000000",
    "number": "1922027853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "862 PEACHWOOD DR",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327200834",
            "telephone_number": "386-740-7080",
            "fax_number": "386-734-0821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 W PLYMOUTH AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327203134",
            "telephone_number": "386-740-7080",
            "fax_number": "386-734-0821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANKIN",
        "first_name": "BRUCE",
        "middle_name": "GLENN",
        "name_prefix": "Dr.",
        "credential": "D. O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2019-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "0S6029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deland, FL

Sources for this page

Verify at the official NPI Registry.