Organization Active NPI

Genesis Health and Wellness, LLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Fort Walton Beach, FL
National Provider Identifier
1477022028
Registry record updated Jul 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
Legal business name
GENESIS HEALTH AND WELLNESS, LLC
Practice address
348 Miracle Strip Pkwy SW Ste 16a
Fort Walton Beach, FL 32548-5258
Phone
(850) 200-4353
Fax
(850) 362-6566
NPI assigned
Nov 13, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2019

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

Authorized official

Name
Dr. Feguens Joseph Bataille, MD
Title
President
Phone
(850) 200-4353

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P2900X Primary
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X

Addresses

Primary practice location

348 Miracle Strip Pkwy SW Ste 16a
Fort Walton Beach, FL 32548-5258

Mailing address

348 Miracle Strip Pkwy SW Ste 16a
Fort Walton Beach, FL 32548-5258
Phone (850) 200-4353

Other names 1

  • Premier Interventional Pain Solutions Doing business as

National Provider Directory

National Provider Directory

Locations

348 Miracle Strip Pkwy SW
Ste 16A
Fort Walton Beach, FL 32548
Phone (412) 901-1250

348 Miracle Strip Pkwy SW
Ft Walton Bch, FL 32548
Phone (850) 374-3529

NPI Registry JSON

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

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563148800000",
    "number": "1477022028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "348 MIRACLE STRIP PKWY SW STE 16A",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325485258",
            "telephone_number": "850-200-4353",
            "fax_number": "850-362-6566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "348 MIRACLE STRIP PKWY SW STE 16A",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325485258",
            "telephone_number": "850-200-4353",
            "fax_number": "850-362-6566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS HEALTH AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-13",
        "last_updated": "2019-07-15",
        "status": "A",
        "authorized_official_last_name": "BATAILLE",
        "authorized_official_first_name": "FEGUENS",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-200-4353",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Interventional Pain Solutions",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Premier Interventional Pain Solutions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 15, 2019; 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.