Active NPI
Genesis Health and Wellness, LLC
- Pain Medicine (Physical Medicine & Rehabilitation) Physician
- Fort Walton Beach, FL
National Provider Identifier
1477022028
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine (Physical Medicine & Rehabilitation) Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine (Physical Medicine & Rehabilitation) Physician | 2081P2900X | Primary | ||
| Pain Medicine Physician | 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
National Provider Directory
National Provider DirectoryLocations
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.