NPIMap

Organization Active NPI

Bass Lake Inpatient Services, LLC

  • Internal Medicine Physician
  • Fort Walton Beach, FL
National Provider Identifier
1467886267
Registry record updated Aug 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
BASS LAKE INPATIENT SERVICES, LLC
Practice address
1000 Mar Walt Dr
Fort Walton Beach, FL 32547-6708
Phone
(850) 862-0213
Fax
(800) 305-3233
NPI assigned
Aug 28, 2013
Last updated
Aug 28, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2013

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

Authorized official

Name
Dr. Gregory J Byrne, MDNPI 1043269384
Title
Owner & President , Inpatient SVCS
Phone
(800) 444-7009

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

1000 Mar Walt Dr
Fort Walton Beach, FL 32547-6708

Mailing address

PO Box 37944
Philadelphia, PA 19101-0544
Phone (800) 444-7009

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1377648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377648000000",
    "number": "1467886267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37944",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191010544",
            "telephone_number": "800-444-7009",
            "fax_number": "800-305-3233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MAR WALT DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476708",
            "telephone_number": "850-862-0213",
            "fax_number": "800-305-3233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BASS LAKE INPATIENT SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-28",
        "last_updated": "2013-08-28",
        "status": "A",
        "authorized_official_last_name": "BYRNE",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER & PRESIDENT , INPATIENT SVCS",
        "authorized_official_telephone_number": "800-444-7009",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "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 Aug 28, 2013; 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.