NPIMap

Baycare Medical Group Inc

Organization Active NPI Family Medicine Physician · St Petersburg, FL

NPI 1548933682 · NPPES record last updated Jul 26, 2021

Key facts

NPI
1548933682
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 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
Organization subpart
No

Authorized official

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

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Jeffrey Jsourbeer MD (202 organizations share this tax ID)

Locations

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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 207Q00000X Yes
Internal Medicine Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 207R00000X
Geriatric Medicine (Internal Medicine) Physician
Group: 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

  • Suncoast Medical Clinic Geriatrics Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 26, 2021.

{
    "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

All providers in St Petersburg, FL · Family Medicine Physician in Florida

Sources for this page

Verify at the official NPI Registry.