NORTH BREVARD MEDICAL SUPPORT, INC
NPI 1033883764
Family Medicine in Port St John, FL

NPI Status: Active since August 05, 2021

Contact Information

5005 PORT ST JOHN PKWY STE 2500
PORT ST JOHN, FL
ZIP 32927
Phone: (321) 504-0556
Fax: (321) 504-0773

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  • Organization
  • Family Medicine
  • Accepts Insurance
  • CLIA Number: 10D1047862
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 11-15-2025

About NORTH BREVARD MEDICAL SUPPORT, INC

This page provides the complete NPI Profile along with additional information for North Brevard Medical Support, Inc, a primary care provider established in Port St John, Florida operating as a Family Medicine. The healthcare provider is registered in the NPI registry with number 1033883764 assigned on August 2021. The practitioner's primary taxonomy code is 207Q00000X. The provider is registered as an organization and their NPI record was last updated 4 years ago. North Brevard Medical Support, Inc operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The authorized official of this NPI record is Kent Andrew Bailey (Vp Finance)

NPI
1033883764
Provider Name
NORTH BREVARD MEDICAL SUPPORT, INC
Entity Type
Organization
Location Address
5005 PORT ST JOHN PKWY STE 2500 PORT ST JOHN, FL 32927
Location Phone
(321) 504-0556
Location Fax
(321) 504-0773
Mailing Address
805 CENTURY MEDICAL DR STE C TITUSVILLE, FL 32796
Mailing Phone
(321) 268-6264
Mailing Fax
(321) 504-0773
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
08-05-2021
Last Update Date
08-05-2021
Code Navigator

A primary care provider (PCP) like North Brevard Medical Support, Inc sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • BlueOptions Bronze (HSA) 24J01-10 (Rewards / $4 Condition Care Rx) - PPO
  • BlueOptions Bronze 24J01-04 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - PPO
  • BlueOptions Bronze 24J01-06 ($0 Virtual PCP Visits / Rewards) - PPO
  • BlueOptions Bronze 24J01-17 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - PPO
  • BlueOptions Bronze 24J01-18S (Multilingual Available / Rewards) - PPO
  • BlueOptions Gold 24J01-09 ($0 Virtual PCP Visits / $15 PCP Visits / Rewards) - PPO
  • BlueOptions Gold 24J01-12 ($0 Virtual PCP Visits / $15 Labs / Rewards) - PPO
  • BlueOptions Gold 24J01-20S ($30 PCP Visits / Multilingual Available / Rewards) - PPO
  • BlueOptions Platinum 24J01-05 ($0 Virtual PCP Visits / $0 Labs / $15 PCP Visits / Rewards) - PPO
  • BlueOptions Platinum 24J01-08 ($0 Virtual PCP Visits / $0 Labs / $10 PCP Visits / Rewards) - PPO
  • BlueOptions Platinum 24J01-21S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards) - PPO
  • BlueOptions Silver 24J01-03 ($0 Virtual PCP Visits / $0 Labs / Rewards) - PPO
  • BlueOptions Silver 24J01-07 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - PPO
  • BlueOptions Silver 24J01-19S ($40 PCP Visits / Multilingual Available / Rewards) - PPO
  • BlueSelect Bronze (HSA) 1735 (Rewards / $4 Condition Care Rx) - EPO
  • BlueSelect Bronze 1449 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - EPO
  • BlueSelect Bronze 2139 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - EPO
  • BlueSelect Bronze 2139E ($0 Virtual PCP Visits / $50 PCP Visits / Adult Dental & Vision / Rewards) - EPO
  • BlueSelect Bronze 2139V ($0 Virtual PCP Visits / $50 PCP Visits / Adult Vision / Rewards) - EPO
  • BlueSelect Bronze 2342S ($50 PCP Visits / Multilingual Available / Rewards) - EPO
  • BlueCare Bronze (HSA) 24K01-09 (Rewards / $4 Condition Care Rx) - POS
  • BlueCare Bronze 24K01-03 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - POS
  • BlueCare Bronze 24K01-05 ($0 Virtual PCP Visits / Rewards) - POS
  • BlueCare Bronze 24K01-25 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - POS
  • BlueCare Bronze 24K01-31S (Multilingual Available / Rewards) - POS
  • BlueCare Bronze 24K02-17 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - POS
  • BlueCare Bronze 24K02-18 ($0 Virtual PCP Visits / Rewards) - POS
  • BlueCare Bronze 24K02-23 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - POS
  • BlueCare Bronze 24K02-26S (Multilingual Available / Rewards) - POS
  • BlueCare Gold 24K01-08 ($0 Virtual PCP Visits / $15 PCP Visits / Rewards) - POS
  • BlueCare Gold 24K01-10 ($0 Virtual PCP Visits / $15 Labs / Rewards) - POS
  • BlueCare Gold 24K01-33S ($30 PCP Visits / Multilingual Available/ Rewards) - POS
  • BlueCare Gold 24K02-20 ($0 Virtual PCP Visits / $15 PCP Visits / Rewards) - POS
  • BlueCare Gold 24K02-28S ($30 PCP Visits / Multilingual Available / Rewards) - POS
  • BlueCare Platinum 24K01-04 ($0 Virtual PCP Visits / $0 Labs / $15 PCP Visits / Rewards) - POS
  • BlueCare Platinum 24K01-07 ($0 Virtual PCP Visits / $0 Labs / $10 PCP Visits / Rewards) - POS
  • BlueCare Platinum 24K01-34S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards) - POS
  • BlueCare Platinum 24K02-15 ($0 Virtual PCP Visits / $0 Labs / $10 PCP Visits / Rewards) - POS
  • BlueCare Platinum 24K02-29S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards) - POS
  • BlueCare Silver 24K01-02 ($0 Virtual PCP Visits / $0 Labs / Rewards) - POS

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

KENT ANDREW BAILEY

Authorized Official Title
VP FINANCE
Authorized Official Phone
(321) 268-6111

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
10D1047862
Facility Type
Physician Office
Certificate Effective Date
November 16, 2023
Certificate Expiration Date
November 15, 2025
Laboratory Director
BENJAMIN NETTLETON
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to North Brevard Medical Support, Inc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for NORTH BREVARD MEDICAL SUPPORT, INC

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1033883764
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
20631686712
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 6 + 3 + 1 + 6 + 8 + 6 + 7 + 1 + 2 + 24 = 66
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 66 = 44

The NPI number 1033883764 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 3 providers are registered at the same or nearby location.

DR. NAGAMANI KURUSANGANAPALLI M.D

Internal Medicine

5005 PORT ST JOHN PKWY STE 2500
PORT ST JOHN, FL
ZIP 32927

(321) 504-0556

DR. CARMEN E. MORALES M.D.

Internal Medicine

5005 PORT ST JOHN PKWY STE 2500
PORT ST JOHN, FL
ZIP 32927

(321) 504-0556

MS. RACHEL MAYE LOEFFLER ARNP, NP-C

Nurse Practitioner

(Family)

5005 PORT ST JOHN PKWY STE 2500
COCOA, FL
ZIP 32927

(321) 504-0556

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1033883764, enumerated as an "organization" on August 05, 2021.

The provider is located at 5005 PORT ST JOHN PKWY STE 2500 PORT ST JOHN, FL 32927 and the phone number is (321) 504-0556.

Family Medicine with taxonomy code 207Q00000X.

The provider might be accepting Accepts: Florida Blue (BlueCross BlueShield FL) and Florida. Please consult your insurance carrier or call the provider to verify.