NPIMap

Organization Active NPI

McCollough Plastic Surgery Clinic

  • Specialist
  • Gulf Breeze, FL
National Provider Identifier
1205046760
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME91684 Issued in FL
Legal business name
MCCOLLOUGH PLASTIC SURGERY CLINIC
Practice address
1040 Gulf Breeze Pkwy
Suite 207
Gulf Breeze, FL 32561-4838
Phone
(850) 934-6880
NPI assigned
May 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Nathan Patterson, M.D.
Title
Physician
Phone
(850) 934-6880

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X ME91684 FL Primary

Addresses

Primary practice location

1040 Gulf Breeze Pkwy
Suite 207
Gulf Breeze, FL 32561-4838

Mailing address

1040 Gulf Breeze Pkwy
Suite 207
Gulf Breeze, FL 32561-4838
Phone (850) 934-6880

National Provider Directory

National Provider Directory
Tax ID family
E Gaylon McCollough MD LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205046760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 GULF BREEZE PKWY",
            "address_2": "SUITE 207",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325614838",
            "telephone_number": "850-934-6880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 GULF BREEZE PKWY",
            "address_2": "SUITE 207",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325614838",
            "telephone_number": "850-934-6880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCCOLLOUGH PLASTIC SURGERY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "850-934-6880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME91684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulf Breeze, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.