Organization Active NPI

Baptist Physician Group LLC

  • Orthopaedic Surgery Physician
  • Pensacola, FL
National Provider Identifier
1609392018
Registry record updated Aug 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
BAPTIST PHYSICIAN GROUP LLC
Practice address
9400 University Pkwy Ste 101a
Pensacola, FL 32514-5485
Phone
(850) 916-3700
Fax
(850) 916-3710
NPI assigned
Aug 17, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2017

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)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QS0010X
Sports Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RS0010X
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X

Addresses

Primary practice location

9400 University Pkwy Ste 101a
Pensacola, FL 32514-5485

Mailing address

PO Box 30532
Pensacola, FL 32503-1532
Phone (850) 478-1312

Other identifiers 2

IdentifierTypeStateIssuer
39662OtherFLFLORIDA BLUE
001330100MedicaidFL

National Provider Directory

National Provider Directory

Locations

1020 Gulf Breeze Pkwy
Ste 208
Gulf Breeze, FL 32561

1020 Gulf Breeze Pkwy
Ste 204
Gulf Breeze, FL 32561

5100 N 12th Ave
Ste 102
Pensacola, FL 32504
Phone (448) 337-7200

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1502928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1502928000000",
    "number": "1609392018",
    "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": "9400 UNIVERSITY PKWY STE 101A",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325145485",
            "telephone_number": "850-916-3700",
            "fax_number": "850-916-3710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST PHYSICIAN GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-17",
        "last_updated": "2017-08-17",
        "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": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "39662",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001330100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Aug 17, 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.

Verify at the official NPI Registry.