Kyle Kit Shaddix, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

ME99596 Issued in FL

Practice address

5147 N 9TH Ave
Ste 203
Pensacola, FL 32504-8771

Phone

(850) 476-7100

Fax

(850) 479-6042

NPI assigned

Aug 8, 2008

Last updated

Jul 26, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• University of Florida Jacksonville Physicians, Inc.

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1144276452

  Surgery

  Medicare reassignment NPD
• Novo Plastic Surgery LLC

  • Plastic and Reconstructive Surgery Physician
  • Pensacola, FL
  • NPI 1740674464
  Authorized official Same address or phone
• McMahon & Ricketson MD PA

  • Surgery Physician
  • Pensacola, FL
  • NPI 1235149048
  NPD
• University of Florida Jacksonville Physicians Inc

  • Surgery Physician
  • Jacksonville, FL
  • NPI 1588824858
  NPD
• University of Florida Jacksonville Physicians, Inc.

  dba UF Health Imaging Center-Baymeadows

  • Physiological Laboratory
  • Jacksonville, FL
  • NPI 1831800952
  NPD

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

{
    "created_epoch": "1218153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437868800000",
    "number": "1346496460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5147 N 9TH AVE",
            "address_2": "STE. 203",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048771",
            "telephone_number": "850-476-7100",
            "fax_number": "850-479-6042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5147 N 9TH AVE",
            "address_2": "STE 203",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048771",
            "telephone_number": "850-476-7100",
            "fax_number": "850-479-6042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHADDIX",
        "first_name": "KYLE",
        "middle_name": "KIT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-08",
        "last_updated": "2015-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "ME99596",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME99596",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013852500",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003155317A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandon Michael Seuzeneau, ATC
• Sara Scrivner Seuzeneau, APRN
• Seville Allergy and Asthma Center, P.a.
• Georgia Linda Sfanos Capel
• Kevin B Shacket, PSYD
• Meredith Lynn Shaddix, DO
• Linda Ruth Shade, C.R.N.A.
• Clayton J Shaeffer, DC
• Nandita A Shah
• Viraj Rajiv Shah

• Plastic Surgery Physician in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Plastic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.