Southmed

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME77622 Issued in FL

Legal business name

SOUTHMED

Practice address

3138 Northside Dr
Key West, FL 33040-8028

Phone

(305) 295-3838

Fax

(305) 295-7772

NPI assigned

Nov 14, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Mark A Baurr

Title

Office Manager

Phone

(305) 295-3838

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1427120765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3138 NORTHSIDE DR",
            "city": "KEY WEST",
            "state": "FL",
            "postal_code": "330408028",
            "telephone_number": "305-295-3838",
            "fax_number": "305-295-7772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3138 NORTHSIDE DR",
            "city": "KEY WEST",
            "state": "FL",
            "postal_code": "330408028",
            "telephone_number": "305-295-3838",
            "fax_number": "305-295-7772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHMED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BAURR",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "305-295-3838",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME77622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "25768102",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Key West, FL
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• 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.