NPIMap

Organization Active NPI

Bangus Surgical Specialists LLC

  • Surgery Physician
  • Panama City, FL
National Provider Identifier
1174221196
Registry record updated Feb 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
BANGUS SURGICAL SPECIALISTS LLC
Practice address
2202 State Ave Ste 108B
Panama City, FL 32405-4539
Phone
(850) 249-1000
NPI assigned
Feb 20, 2023
Last updated
Feb 20, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2023

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

Authorized official

Name
Kathleen Kondas
Title
Officer
Phone
(973) 251-1132

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

2202 State Ave Ste 108B
Panama City, FL 32405-4539

Mailing address

5565 Centerview Dr Ste 107
Raleigh, NC 27606-3563
Phone (973) 251-1132

National Provider Directory

National Provider Directory
Tax ID family
Bangus Surgical Specialists LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1676851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676851200000",
    "number": "1174221196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5565 CENTERVIEW DR STE 107",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276063563",
            "telephone_number": "973-251-1132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 STATE AVE STE 108B",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054539",
            "telephone_number": "850-249-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANGUS SURGICAL SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-20",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-15",
        "status": "A",
        "authorized_official_last_name": "KONDAS",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "973-251-1132"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.