Active NPI
Baptist Physician Group LLC
- Orthopaedic Surgery Physician
- Pensacola, FL
National Provider Identifier
1609392018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- 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
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 | |||
| Sports Medicine (Internal Medicine) Physician | 207RS0010X | |||
| Orthopaedic Surgery Physician | 207X00000X | Primary | ||
| Physician Assistant | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39662 | Other | FL | FLORIDA BLUE |
| 001330100 | Medicaid | FL |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Hospice and Palliative Medicine (Family Medicine) Physician
- Pensacola, FL
- NPI 1528158458
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.