Organization Active NPI

Nephrology Associates of the Gulf Coast, PA

Doing business as Nephrology Associates of the Gulf Coast

  • Nephrology Physician
  • Pensacola, FL
National Provider Identifier
1477539914
Registry record updated Nov 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
NEPHROLOGY ASSOCIATES OF THE GULF COAST, PA
Doing business as
Nephrology Associates of the Gulf Coast
Practice address
8333 N Davis Hwy
Pensacola, FL 32514-6050
Phone
(850) 474-8121
Fax
(850) 474-8096
NPI assigned
Dec 16, 2005
Last updated
Nov 11, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2022

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

Authorized official

Name
Gary Smith
Title
Practice Administrator
Phone
(850) 474-8121

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary
Home Health Agency 251E00000X

Addresses

Primary practice location

8333 N Davis Hwy
Pensacola, FL 32514-6050

Mailing address

8333 N Davis Hwy
Pensacola, FL 32514-6050
Phone (850) 474-8121

Other identifiers 3

IdentifierTypeStateIssuer
72272OtherFLBLUE CROSS BLUE SHIELD
529927050MedicaidAL
274039700MedicaidFL

Other names 1

  • Nephrology Associates of the Gulf Coast Doing business as

National Provider Directory

National Provider Directory

Locations

1023 Douglas Ave
Brewton, AL 36426
Phone (251) 867-3924

4415 US Highway 331 S
Ste A
Defuniak Springs, FL 32435

1110 Hospital Rd
#1A
Fort Walton Beach, FL 32547
Phone (850) 862-6989

5819 Highway 90
Milton, FL 32583
Phone (850) 623-8299

812 Creighton Rd
Pensacola, FL 32504
Phone (850) 564-6644

Practitioners & affiliated clinicians

Practitioners 3

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": "1134691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668124800000",
    "number": "1477539914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8333 N DAVIS HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325146050",
            "telephone_number": "850-474-8121",
            "fax_number": "850-474-8096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8333 N DAVIS HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325146050",
            "telephone_number": "850-474-8121",
            "fax_number": "850-474-8096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEPHROLOGY ASSOCIATES OF THE GULF COAST, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-16",
        "last_updated": "2022-11-11",
        "certification_date": "2022-11-07",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "850-474-8121"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "72272",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529927050",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274039700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nephrology Associates of the Gulf Coast",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2022; 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.