NPIMap

Organization Active NPI

Baycare Medical Group Inc

  • Family Medicine Physician
  • St Petersburg, FL
National Provider Identifier
1548933682
Registry record updated Jul 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BAYCARE MEDICAL GROUP INC
Practice address
500 Dr Martin Luther King Jr St N Ste 300
St Petersburg, FL 33705-1470
Phone
(727) 824-8257
Fax
(727) 502-4057
NPI assigned
Jul 26, 2021
Last updated
Jul 26, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2021

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

Authorized official

Name
Lynda Gorken
Title
VP, PFS
Phone
(727) 281-9202

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RG0300X

Addresses

Primary practice location

500 Dr Martin Luther King Jr St N Ste 300
St Petersburg, FL 33705-1470

Mailing address

2995 Drew St FL 3
Clearwater, FL 33759-3012

Other names 1

  • Suncoast Medical Clinic Geriatrics Other name

National Provider Directory

National Provider Directory
Tax ID family
Mark Awhiting MD202 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

500 Dr Martin Luther King Jr St N
Ste 300
St Petersburg, FL 33705
Phone (727) 824-8257

NPI Registry JSON

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

{
    "created_epoch": "1627257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627257600000",
    "number": "1548933682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2995 DREW ST FL 3",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337593012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 DR MARTIN LUTHER KING JR ST N STE 300",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337051470",
            "telephone_number": "727-824-8257",
            "fax_number": "727-502-4057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYCARE MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-26",
        "last_updated": "2021-07-26",
        "certification_date": "2021-06-29",
        "status": "A",
        "authorized_official_last_name": "GORKEN",
        "authorized_official_first_name": "LYNDA",
        "authorized_official_title_or_position": "VP, PFS",
        "authorized_official_telephone_number": "727-281-9202"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Suncoast Medical Clinic Geriatrics",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; 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.