NPIMap

Organization Active NPI

Pensacola Ear Nose and Throat PL

  • Otolaryngology Physician
  • Pensacola, FL
National Provider Identifier
1164480240
Registry record updated Sep 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
PENSACOLA EAR NOSE AND THROAT PL
Practice address
1717 North E Street
Ste 239
Pensacola, FL 32501
Phone
(850) 432-3467
Fax
(850) 434-2308
NPI assigned
May 1, 2006
Last updated
Sep 24, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2014

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

Authorized official

Name
Dr. Kevin Botts Jr., MDNPI 1982662094
Title
Partner
Phone
(850) 532-3467

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X NU Primary

Addresses

Primary practice location

1717 North E Street
Ste 239
Pensacola, FL 32501

Mailing address

1717 North E Street
Ste 239
Pensacola, FL 32501
Phone (850) 432-3467

Other identifiers 2

IdentifierTypeStateIssuer
39522OtherFLBLUE CROSS BLUE SHIELD
276479200MedicaidFL

National Provider Directory

National Provider Directory

Locations

1717 N E St
Ste 239
Pensacola, FL 32501
Phone (850) 432-3467

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411516800000",
    "number": "1164480240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 NORTH E STREET",
            "address_2": "STE 239",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "32501",
            "telephone_number": "850-432-3467",
            "fax_number": "850-434-2308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 NORTH E STREET",
            "address_2": "STE 239",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "32501",
            "telephone_number": "850-432-3467",
            "fax_number": "850-434-2308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENSACOLA EAR NOSE AND THROAT PL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-01",
        "last_updated": "2014-09-24",
        "status": "A",
        "authorized_official_last_name": "BOTTS",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "850-532-3467",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "39522",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "276479200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2014; 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.