Baptist Physician Group LLC

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

Legal business name

BAPTIST PHYSICIAN GROUP LLC

Practice address

1040 Gulf Breeze Pkwy
Suite 200
Gulf Breeze, FL 32561-7809

Phone

(850) 916-3700

Fax

(850) 916-3710

NPI assigned

May 29, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Bryon Scott Raynes

Title

President

Phone

(850) 469-2319

Specialties & licenses 4

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1659572816",
    "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": "850-916-3700",
            "fax_number": "850-916-3710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 GULF BREEZE PKWY",
            "address_2": "SUITE 200",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325617809",
            "telephone_number": "850-916-3700",
            "fax_number": "850-916-3710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST PHYSICIAN GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2022-07-21",
        "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",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001330100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "39662",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110608",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Baptist Medical Group LLC
• Baptist Medical Group LLC
• Baptist Medical Group LLC
• Baptist Medical Group LLC
• Baptist Medical Group LLC
• Charles Garrett Barnes, P.A.
• Marley Barone
• Sarah M Baroni, PA-C
• Betsy Welsh Barrett, CF-SLP
• Nicole Barrineau, DDS

• Sports Medicine (Orthopaedic Surgery) Physician in Gulf Breeze, FL
• Providers in Gulf Breeze, FL by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.