Active NPI
Baptist Physician Group LLC
- Orthopaedic Surgery Physician
- Navarre, FL
National Provider Identifier
1609391929
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- Legal business name
- BAPTIST PHYSICIAN GROUP LLC
- Practice address
- 8880 Navarre Pkwy Ste 206
Navarre, FL 32566-3614 - Phone
- (850) 916-8697
- Fax
- (860) 916-8666
- NPI assigned
- Aug 8, 2017
- Last updated
- Aug 8, 2017
- 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
- Bryon Scott Raynes
- Title
- President
- Phone
- (850) 469-2319
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Family Medicine) Physician | 207QS0010X | NU | ||
| Orthopaedic Surgery Physician | 207X00000X | NU | Primary | |
| Sports Medicine (Physical Medicine & Rehabilitation) Physician | 2081S0010X | NU | ||
| Physician Assistant | 363A00000X | NU |
Addresses
Primary practice location
8880 Navarre Pkwy Ste 206
Navarre, FL 32566-3614
Mailing address
PO Box 30532
Pensacola, FL 32503-1532
Phone (850) 478-1312
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110608 | Medicaid | AL | |
| 001330100 | Medicaid | FL | |
| 39662 | Other | FL | FLORIDA BLUE |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502150400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1502150400000",
"number": "1609391929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 30532",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325031532",
"telephone_number": "850-478-1312",
"fax_number": "850-474-9060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8880 NAVARRE PKWY STE 206",
"city": "NAVARRE",
"state": "FL",
"postal_code": "325663614",
"telephone_number": "850-916-8697",
"fax_number": "860-916-8666"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BAPTIST PHYSICIAN GROUP LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-08-08",
"last_updated": "2017-08-08",
"status": "A",
"authorized_official_last_name": "RAYNES",
"authorized_official_first_name": "BRYON",
"authorized_official_middle_name": "SCOTT",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "850-469-2319"
},
"taxonomies": [
{
"code": "207QS0010X",
"taxonomy_group": "",
"desc": "Family Medicine, Sports Medicine",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "2081S0010X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation, Sports Medicine",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110608",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001330100",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FLORIDA BLUE",
"identifier": "39662",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Navarre, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.