Individual provider Active NPI

Brian Parker, PA-C

  • Physician Assistant
  • Tallahassee, FL
National Provider Identifier
1992708549
Registry record updated Jul 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9100961 Issued in FL
Practice address
3334 Capital Medical Blvd
Ste 400
Tallahassee, FL 32308-8405
Phone
(850) 877-8174
Fax
(850) 877-5636
NPI assigned
May 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9100961 FL Primary

Addresses

Primary practice location

3334 Capital Medical Blvd
Ste 400
Tallahassee, FL 32308-8405

Mailing address

3334 Capital Medical Blvd
Ste 400
Tallahassee, FL 32308-8405
Phone (850) 877-8174

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
I20070131000502 FL Practitioner - Physician Assistant 6103828397 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tallahassee Orthopedic Clinic III, P.L. CurrentSince Aug 9, 1999 Accepting new patients
Tallahassee Orthopedic Clinic III PL CurrentSince Aug 9, 1999 Accepting new patients
Coastal Orthopedics & Sports Medicine of Southwest Florida PA Past Accepting new patients
Tallahassee Orthopedic Clinic III PL Past Accepting new patients

Locations

803 W Main St
Perry, FL 32347
Phone (850) 584-7078

3334 Capital Medical Blvd
Ste 500
Tallahassee, FL 32308
Phone (850) 877-4688

3334 Capital Medical Blvd
Tallahassee, FL 32308
Phone (850) 210-1808

3334 Capital Medical Blvd
Ste 400
Tallahassee, FL 32308

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": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1992708549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3334 CAPITAL MEDICAL BLVD",
            "address_2": "STE 400",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323088405",
            "telephone_number": "850-877-8174",
            "fax_number": "850-877-5636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3334 CAPITAL MEDICAL BLVD",
            "address_2": "STE 400",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323088405",
            "telephone_number": "850-877-8174",
            "fax_number": "850-877-5636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "BRIAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9100961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.