Individual provider Active NPI

Brianna L Willetts, APRN

  • Family Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1962166397
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11015576 Issued in FL
Practice address
7751 Baymeadows Rd E Ste H
Jacksonville, FL 32256-5836
Phone
(904) 425-6963
Fax
(904) 674-0155
NPI assigned
Oct 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11015576 FL Primary

Addresses

Primary practice location

7751 Baymeadows Rd E Ste H
Jacksonville, FL 32256-5836

Mailing address

2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342
Phone (877) 856-3774

Other names 1

  • Brianna Beiber Former name

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
I20220214001430 FL Practitioner - Nurse Practitioner 8224421318 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

2377 Dunn Ave
Jacksonville, FL 32218-6983
Phone (904) 648-8090

Hospital & facility affiliations

  • Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
  • HCA Florida Memorial Hospital Hospital, Jacksonville, FL, CCN 100179

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC CurrentSince Sep 19, 2022 Accepting new patients
University of Florida Jacksonville Physicians Inc CurrentSince Feb 14, 2022 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Feb 14, 2022 Accepting new patients
University of Florida Jacksonville Physicians Inc Current Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Feb 14, 2022 Accepting new patients
Millennium Physician Group LLC CurrentSince Sep 19, 2022 Accepting new patients
University of Florida Jacksonville Physicians Inc Current Accepting new patients

Locations

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

7751 Baymeadows Rd E
Ste H
Jacksonville, FL 32256
Phone (904) 425-6963

1255 Lila St
Jacksonville, FL 32208
Phone (904) 244-5700

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

2377 Dunn Ave
Jacksonville, FL 32218
Phone (904) 633-0700

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

Interoperability endpoints

  • Direct secure messaging: brianna.bieber.1@4290.direct.athenahealth.com

Organizations & group practices 7

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.

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": "1634860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1962166397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7751 BAYMEADOWS RD E STE H",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322565836",
            "telephone_number": "904-425-6963",
            "fax_number": "904-674-0155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLETTS",
        "first_name": "BRIANNA",
        "middle_name": "L",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-22",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11015576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIANNA",
            "last_name": "BEIBER",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.