Oliver Kenneth Bayouth III, DO

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

UO8872 Issued in FL

Practice address

7975 Lake Underhill Rd Ste 200
Orlando, FL 32822-8204

Phone

(407) 303-6830

NPI assigned

May 22, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Interoperability endpoints

• Direct secure messaging: obayouthiii1130465@adventhealth.direct-ci.com

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

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1104518802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7975 LAKE UNDERHILL RD STE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328228204",
            "telephone_number": "407-303-6830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7975 LAKE UNDERHILL RD STE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328228204",
            "telephone_number": "407-303-6830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAYOUTH",
        "first_name": "OLIVER",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "UO8872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sophie L Bayne
• Valencia Bayne, PHARMD
• Jaime Ann Baynes-Fields, D.O.
• Yadira E Bayona-Salcedo, M.D.
• Lana A Bayona, M.S
• Oliver Kenneth Bayouth Jr., MD
• Bayview Medical Supply LLC
• Juana Baza Martinez, RBT
• John Bazata, DPM
• Janelly Bazil

• Student in an Organized Health Care Education/Training Program in Orlando, FL
• Providers in Orlando, FL by specialty
• Student in an Organized Health Care Education/Training Program in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.