Organization Active NPI

Dress Reconstructive Surgery, P.a.

  • Plastic Surgery Physician
  • Fort Walton Beach, FL
National Provider Identifier
1194077099
Registry record updated Oct 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
ME87448 Issued in FL
Legal business name
DRESS RECONSTRUCTIVE SURGERY, P.A.
Practice address
11 Racetrack Rd NE
Ste. E4
Fort Walton Beach, FL 32547-1882
Phone
(850) 200-4575
Fax
(850) 200-4576
NPI assigned
Oct 3, 2012
Last updated
Oct 3, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2012

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

Authorized official

Name
Christopher Michael Dress, M.D.NPI 1962472142
Title
Owner/Plastic Surgeon
Phone
(850) 362-6191

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X ME87448 FL Primary

Addresses

Primary practice location

11 Racetrack Rd NE
Ste. E4
Fort Walton Beach, FL 32547-1882

Mailing address

11 Racetrack Rd NE
Ste. E4
Fort Walton Beach, FL 32547-1882
Phone (850) 200-4575

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1349222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349222400000",
    "number": "1194077099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 RACETRACK RD NE",
            "address_2": "STE. E4",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325471882",
            "telephone_number": "850-200-4575",
            "fax_number": "850-200-4576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 RACETRACK RD NE",
            "address_2": "STE. E4",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325471882",
            "telephone_number": "850-200-4575",
            "fax_number": "850-200-4576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRESS RECONSTRUCTIVE SURGERY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-03",
        "last_updated": "2012-10-03",
        "status": "A",
        "authorized_official_last_name": "DRESS",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER/PLASTIC SURGEON",
        "authorized_official_telephone_number": "850-362-6191",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "ME87448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2012; 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.