NPIMap

Organization Active NPI

Big Bend Hospice, Inc.

  • Family Medicine Physician
  • Tallahassee, FL
National Provider Identifier
1033791199
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BIG BEND HOSPICE, INC.
Doing business as
Big Bend Hospice, Inc.
Practice address
1723 Mahan Center Blvd
Tallahassee, FL 32308-5428
Phone
(702) 960-2272
NPI assigned
Apr 27, 2021
Last updated
Apr 27, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Pam Gibson
Title
Executive Assistance / Board Liaiso
Phone
(850) 878-5310

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

1723 Mahan Center Blvd
Tallahassee, FL 32308-5428

Mailing address

1723 Mahan Center Blvd
Tallahassee, FL 32308-5428
Phone (702) 960-2272

Other identifiers 2

IdentifierTypeStateIssuer
087524401MedicaidFL
087524400MedicaidFL

Other names 1

  • Big Bend Hospice, Inc. Doing business as

National Provider Directory

National Provider Directory
Tax ID family
7 Oaks Healthcare Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1619481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619481600000",
    "number": "1033791199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1723 MAHAN CENTER BLVD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085428",
            "telephone_number": "702-960-2272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1723 MAHAN CENTER BLVD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085428",
            "telephone_number": "702-960-2272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIG BEND HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-27",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "EXECUTIVE ASSISTANCE / BOARD LIAISO",
        "authorized_official_telephone_number": "850-878-5310"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "087524401",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "087524400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Big Bend Hospice, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.