NPIMap

Organization Active NPI

Bayside Medical Group

  • Family Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1154879443
Registry record updated Sep 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP3380082 Issued in FL
Legal business name
BAYSIDE MEDICAL GROUP
Practice address
6228 Greenwich Dr
Tampa, FL 33647-1142
Phone
(813) 679-7670
Fax
(813) 977-8009
NPI assigned
Sep 14, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2016

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

Authorized official

Name
Mr. Martin Akachukwu Esuzor, ARNPN
Title
Arnp Rrovider
Phone
(813) 679-7670

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X ARNP3380082 FL Primary

Addresses

Primary practice location

6228 Greenwich Dr
Tampa, FL 33647-1142

Mailing address

6228 Greenwich Dr
Tampa, FL 33647-1142
Phone (813) 679-7670

Other names 1

  • None Former legal business name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1473811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473811200000",
    "number": "1154879443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6228 GREENWICH DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336471142",
            "telephone_number": "813-679-7670",
            "fax_number": "813-977-8009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6228 GREENWICH DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336471142",
            "telephone_number": "813-679-7670",
            "fax_number": "813-977-8009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSIDE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-14",
        "last_updated": "2016-09-14",
        "status": "A",
        "authorized_official_last_name": "ESUZOR",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "AKACHUKWU",
        "authorized_official_title_or_position": "ARNP RROVIDER",
        "authorized_official_telephone_number": "813-679-7670",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ARNPN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP3380082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "None",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2016; 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.