NPIMap

Individual provider Active NPI

John Byrd

  • Internal Medicine Physician
  • Graceville, FL
National Provider Identifier
1073932828
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME129136 Issued in FL
Practice address
5429 College Dr
Graceville, FL 32440-1858
Phone
(850) 263-0639
NPI assigned
Apr 9, 2014
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X ME129136 FL Primary

Addresses

Primary practice location

5429 College Dr
Graceville, FL 32440-1858

Mailing address

5429 College Dr
Graceville, FL 32440-1858
Phone (850) 263-0639

Other practice location 1

2451 Fillingim St
Res Box 7th Floor
Mobile, AL 36617
Phone (251) 471-7207

Other practice location 2

1360 Brickyard Road
P.O. Box 889
Chipley, FL 32428
Phone (850) 415-8188

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171025001823 FL Practitioner - Internal Medicine 1951620707 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1360 Brickyard Rd
Chipley, FL 32428-6303
Phone (850) 638-1610

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME129136FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Florida Healthcare, Inc CurrentSince Sep 1, 2017 Accepting new patients
Northwest Florida Healthcare, Inc CurrentSince Sep 1, 2017 Accepting new patients
Southland Hospitlalist at Chipley, PL. CurrentSince Dec 3, 2017 Accepting new patients
Northwest Florida Healthcare, Inc Internal Medicine Past Accepting new patients

Locations

1360 Brickyard Rd
Chipley, FL 32428
Phone (850) 415-8300

1360 Brickyard Rd
Fl Co
Chipley, FL 32428
Phone (850) 638-1610

1376 Brickyard Rd
Chipley, FL 32428
Phone (850) 638-0552

5429 College Dr
Graceville, FL 32440
Phone (850) 263-0639

Interoperability endpoints

  • Direct secure messaging: john.byrd.1@14612.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1397001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1073932828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5429 COLLEGE DR",
            "city": "GRACEVILLE",
            "state": "FL",
            "postal_code": "324401858",
            "telephone_number": "850-263-0639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5429 COLLEGE DR",
            "city": "GRACEVILLE",
            "state": "FL",
            "postal_code": "324401858",
            "telephone_number": "850-263-0639"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2451 Fillingim St",
            "address_2": "Res Box 7th Floor",
            "address_purpose": "LOCATION",
            "city": "Mobile",
            "state": "AL",
            "postal_code": "36617",
            "country_code": "US",
            "telephone_number": "251-471-7207",
            "fax_number": "251-471-7468",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1360 Brickyard Road",
            "address_2": "P.O. Box 889",
            "address_purpose": "LOCATION",
            "city": "Chipley",
            "state": "FL",
            "postal_code": "32428",
            "country_code": "US",
            "telephone_number": "850-415-8188",
            "fax_number": "850-638-0622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BYRD",
        "first_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-09",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME129136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Graceville, FL

Sources for this page

Verify at the official NPI Registry.