John K Badlissi MD PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

JOHN K BADLISSI MD PA

Practice address

2400 Highway 365
Suite 205
Nederland, TX 77627-6249

Phone

(409) 722-1197

Fax

(409) 722-1923

NPI assigned

Aug 27, 2008

Last updated

Jul 25, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John K Badlissi, MDNPI 1578753265

Title

President

Phone

(409) 722-1197

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Southeast Texas Inpatient Physician Associates

  • Hospitalist Physician
  • Port Arthur, TX
  • NPI 1477986891

  Member Of

  NPD member

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Badlissi, MD

  • Internal Medicine Physician
  • Nederland, TX
  • NPI 1578753265
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1219795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343174400000",
    "number": "1659528032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 HIGHWAY 365",
            "address_2": "SUITE 205",
            "city": "NEDERLAND",
            "state": "TX",
            "postal_code": "776276249",
            "telephone_number": "409-722-1197",
            "fax_number": "409-722-1923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 HIGHWAY 365",
            "address_2": "SUITE 205",
            "city": "NEDERLAND",
            "state": "TX",
            "postal_code": "776276249",
            "telephone_number": "409-722-1197",
            "fax_number": "409-722-1923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN K BADLISSI MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-27",
        "last_updated": "2012-07-25",
        "status": "A",
        "authorized_official_last_name": "BADLISSI",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "409-722-1197",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sholanda Michelle Jacobs, NP
• Eduardo L Jaramillo, MD
• Jason Hunt, D.C., P.a. (Nederland Chiropractic)
• Adam Jaynes, FNP
• Ryan Edward Jimenez, PTA
• John L. Forsythe, M.D.P.a
• Jobin John, RPH
• Jeannie Johnson, FNP-C
• Michael Robert Johnson, MPT
• Jon Kevin Jones, PT

• Internal Medicine Physician in Nederland, TX
• Providers in Nederland, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.