1. Home
  2. Directory
  3. Florida
  4. Port St John
  5. Family Medicine
  6. NPI Profile

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

Active since August 05, 2021CLIA 10D2311443 · Waiver
5005 PORT ST JOHN PKWY STE 2500, PORT ST JOHN, FL 32927(321) 504-0556(321) 504-0773 Get Directions Write a Review

NPPES record last updated: August 5, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About North Brevard Medical Support, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NORTH BREVARD MEDICAL SUPPORT, INC (NPI 1033883764) is a healthcare organization registered as a family medicine in Port St John, Florida and active in the NPI registry since August 2021. The organization holds a CLIA Waiver certificate valid through September 22, 2026 and lists Kent Andrew Bailey, Vp Finance, as its authorized official.

NPPES Registry Identity

NPI1033883764
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameNORTH BREVARD MEDICAL SUPPORT, INC
Location Address5005 PORT ST JOHN PKWY STE 2500Port St John, FL 32927-4305
Mailing Address805 Century Medical Dr Ste CTitusville, FL 32796-2100 · (321) 268-6264 · Fax (321) 268-6273
Phone(321) 504-0556
Fax(321) 504-0773
Organization SubpartNo
Authorized OfficialKent Andrew BaileyVp Finance · (321) 268-6111
Enumeration DateAugust 5, 2021
NPPES CertifiedAugust 5, 2021
✔ NPI 1033883764 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
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.
5005 PORT ST JOHN PKWY STE 2500, Port St John, FL 32927
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2311443

North Brevard Medical Support Inc · Titusville, FL
Active · expires Sep 22, 2026
CLIA Number10D2311443
Laboratory TypePhysician Office
Certificate Effective DateSeptember 23, 2024
Certificate Expiration DateSeptember 22, 2026
Laboratory DirectorMarinely Cruz-Amy
Laboratory Phone(321) 268-6831
Laboratory LocationNorth Brevard Medical Support Inc490 N Washington Ave, Titusville, FL 32796
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. RACHEL MAYE LOEFFLER ARNP, NP-C
Nurse Practitioner (Family)
5005 PORT ST JOHN PKWY STE 2500
COCOA, FL 32927
Brevard County (321) 504-0556
DR. NAGAMANI KURUSANGANAPALLI M.D
Internal Medicine
5005 PORT ST JOHN PKWY STE 2500
PORT ST JOHN, FL 32927
Brevard County (321) 504-0556
DR. CARMEN E. MORALES M.D.
Internal Medicine
5005 PORT ST JOHN PKWY STE 2500
PORT ST JOHN, FL 32927
Brevard County (321) 504-0556

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is North Brevard Medical Support, Inc's NPI number?

The NPI number for North Brevard Medical Support, Inc is 1033883764. It was assigned to this organization in the NPPES registry on August 5, 2021.

Where is North Brevard Medical Support, Inc located?

North Brevard Medical Support, Inc is located at 5005 Port St John Pkwy Ste 2500, Port St John, FL 32927. The listed phone number is (321) 504-0556.

What is North Brevard Medical Support, Inc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does North Brevard Medical Support, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2311443) is associated with this NPI, valid through September 22, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does North Brevard Medical Support, Inc accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list North Brevard Medical Support, Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for North Brevard Medical Support, Inc was last updated on August 5, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.