Bittern Emergency Physicians, LLC

Organization Active NPI Emergency Medicine Physician · Perry, FL

NPI 1003487380 · NPPES record last updated Mar 30, 2023

Key facts

NPI
1003487380
Entity type
Organization (NPI type 2)
Primary specialty
Emergency Medicine Physician 207P00000X
Legal business name
BITTERN EMERGENCY PHYSICIANS, LLC
Practice address
333 N Byron Butler Pkwy
Perry, FL 32347-2300
Phone
(973) 251-1132
NPI assigned
Jul 7, 2021
Organization subpart
No

Authorized official

Name
Karen Vaughn
Title
Officer
Phone
(973) 251-1132

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in FL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20140403001260 FL Part B Supplier - Clinic/Group Practice 8426280520 Receives reassigned benefits from 22 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Blountstown, FL

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207P00000X Yes

Addresses

Primary practice location

333 N Byron Butler Pkwy
Perry, FL 32347-2300

Mailing address

5565 Centerview Dr Ste 107
Raleigh, NC 27606-3563
Phone (973) 251-1132

Other providers in Perry, FL

All providers in Perry, FL · Emergency Medicine Physician in Florida

Sources for this page

Verify at the official NPI Registry.