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BASIC
NPI 1104166735
Preferred Provider Organization in Orlando, FL

Active since February 19, 2013
2813 S HIAWASSEE RD, SUITE 201, ORLANDO, FL 32835(407) 378-5100 Get Directions Write a Review

NPPES record last updated: February 19, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Basic NPPES

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

BASIC (NPI 1104166735) is a healthcare organization registered as a preferred provider organization in Orlando, Florida and active in the NPI registry since February 2013. The organization lists Keyne K Johnson, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1104166735
Entity TypeOrganization
Primary Taxonomy305R00000X
Legal Business NameBRAIN AND SPINE INSTATE FOR CHILDREN
Location Address2813 S HIAWASSEE RD, SUITE 201Orlando, FL 32835-6300
Mailing Address2813 S Hiawassee Rd, Suite 201Orlando, FL 32835-6300 · (407) 378-5100
Phone(407) 378-5100
Organization SubpartNo
Authorized OfficialKeyne K JohnsonMedical Director · (407) 378-5100
Enumeration DateFebruary 19, 2013
✔ NPI 1104166735 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPreferred Provider OrganizationManaged Care Organizations
Taxonomy Code305R00000X
License✔ Licensed in FL · ME 102412
Definition
A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level.
2813 S HIAWASSEE RD, Orlando, FL 32835
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Other Names 1

Doing Business AsBasic

Other Identifiers 1

Medicaid000384900FL

Other Providers at the Same Location NPPES 4

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

CARLA BRESNAHAN
Counselor (Mental Health)
2813 S HIAWASSEE RD, #207
ORLANDO, FL 32835
Orange County (407) 325-7546
MRS. KIMBERLEE A RICHARDSON LMHC
Counselor (Mental Health)
2813 S HIAWASSEE RD, STE 207
ORLANDO, FL 32835
Orange County (407) 492-6271
DR. DAVID F SUTTON D.M.D.
Dentist
2813 S HIAWASSEE RD, SUITE 105
ORLANDO, FL 32835
Orange County (407) 578-3093
GLORIA C MARESMA LMHC, LMFT
Marriage & Family Therapist
2813 S HIAWASSEE RD, SUITE 207
ORLANDO, FL 32835
Orange County (407) 446-1402

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 Brain And Spine Instate For Children's NPI number?

The NPI number for Brain And Spine Instate For Children is 1104166735. It was assigned to this organization in the NPPES registry on February 19, 2013. The provider is doing business as Basic.

Where is Brain And Spine Instate For Children located?

Brain And Spine Instate For Children is located at 2813 S Hiawassee Rd Suite 201, Orlando, FL 32835. The listed phone number is (407) 378-5100.

What is Brain And Spine Instate For Children's specialty?

The primary specialty registered for this NPI is Preferred Provider Organization with taxonomy code 305R00000X.

When was this NPI record last updated?

The NPPES record for Brain And Spine Instate For Children was last updated on February 19, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.