ADAM A BRUNSON M.D., NPI 1023011913 — ST PETERSBURG (FL)

NPI 1023011913

14+ Years Experience Individual

ADAM A BRUNSON M.D.

05/24/2005
PROVIDER ENUMERATION DATE
08/15/2011
LAST UPDATE DATE
1023011913
NPI NUMBER

About ADAM A BRUNSON

Sole proprietor? No, Entity Type 1 Provider (Individual) is not a Sole Proprietor.

ADAM A BRUNSON is a provider established in ST PETERSBURG, FL. The NPI number of ADAM A BRUNSON is 1023011913 and was assigned on 05/24/2005. The practitioners primary taxonomy code is: 207Q00000X with license number: ME80751 FL .

Mailing address

  • City: ST PETERSBURG
  • State: FL
  • Postal code: 337161823
  • Phone: 7275614303
  • Fax: 7275619299
  • Address: 12225 28TH ST N
  • Address 2: SUITE B

Primary Practice Address

  • Region : ST PETERSBURG, FL
  • NPI : 1023011913
  • Phone : 7275614303
  • Fax : 7275619299
  • Postalcode : 337161823
  • Address : 12225 28TH ST N SUITE B

Provider taxonomy - Family Medicine

  • Taxonomy code: 207Q00000X
  • License number: ME80751
  • License state: FL

The taxonomy is the primary taxonomy (there can be only one per NPI record).

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.

Contacts:

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  • ADAM A BRUNSON M.D.
  • Address : 12225 28TH ST N SUITE B
  • Region : ST PETERSBURG, FL
  • NPI : 1023011913
  • Phone : 7275614303
  • Fax : 7275619299
  • Postalcode : 337161823

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address12225 28TH ST N
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location AddressSUITE B
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameST PETERSBURG
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameFL
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code337161823
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number7275614303
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number7275619299
The fax number associated with the location address of the provider being identified.
NPI1023011913
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1207Q00000X
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.
Provider Enumeration Date05/24/2005
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated08/15/2011
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)ADAM A BRUNSON
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address12225 28TH ST N
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Second Line Business Mailing AddressSUITE B
The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
Provider Business Mailing Address City NameST PETERSBURG
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameFL
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code337161823
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number7275614303
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number7275619299
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Healthcare Provider Taxonomy Code #1207Q00000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Family Medicine
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.
Provider License Number 1ME80751
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1FL
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Provider Gender CodeM
  • M - male
  • F - female
Is sole proprietorN
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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