NPIMap

Organization Active NPI

Baycare Urgent Care, LLC

  • General Practice Physician
  • St Petersburg, FL
National Provider Identifier
1124694112
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
BAYCARE URGENT CARE, LLC
Practice address
1599 66TH St N
St Petersburg, FL 33710-5536
Phone
(727) 317-3388
NPI assigned
Jun 1, 2021
Last updated
Dec 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

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

Authorized official

Name
Lynda Gorken
Title
VP
Phone
(813) 852-3304

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

1599 66TH St N
St Petersburg, FL 33710-5536

Mailing address

2995 Drew St FL 3
Clearwater, FL 33759-3012
Phone (727) 281-9065

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
MPM Immed Care Centers LLC42 organizations share this tax ID, including this one

Other organizations with this tax ID 41

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

View all 41

Locations

1599 66th St N
St Petersburg, FL 33710
Phone (727) 317-3388

NPI Registry JSON

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

{
    "created_epoch": "1622505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701907200000",
    "number": "1124694112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2995 DREW ST FL 3",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337593012",
            "telephone_number": "727-281-9065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1599 66TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337105536",
            "telephone_number": "727-317-3388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYCARE URGENT CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-01",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A",
        "authorized_official_last_name": "GORKEN",
        "authorized_official_first_name": "LYNDA",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "813-852-3304"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; 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.