NPIMap

Individual provider Active NPI

J David Barr, PAC

  • Physician Assistant
  • Odessa, FL
National Provider Identifier
1679511802
Registry record updated Sep 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9108698 Issued in ZZ
Practice address
16734 Ivy Lake Dr
Odessa, FL 33556-6020
Phone
(813) 459-7711
Fax
(813) 235-4175
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9108698 ZZ Primary

Addresses

Primary practice location

16734 Ivy Lake Dr
Odessa, FL 33556-6020

Mailing address

18865 State Road 54 # 301
Lutz, FL 33558-8201
Phone (813) 459-7711

Other names 1

  • John David Barr Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151019000898 FL Practitioner - Physician Assistant 3779583513 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

16703 Early Riser Ave
Land O Lakes, FL 34638-0192
Phone (727) 698-5989

Hospital & facility affiliations

  • Pinellas 1 Home Health Care Corp Home health agency, Clearwater, FL, CCN 683182
  • St Josephs Hospital Hospital, Tampa, FL, CCN 100075

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9108698ZZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Physicial Medicine & Rehab Consultants Current Accepting new patients
Starpath Orthopaedics & Sports Medicine, Inc. Past Accepting new patients
Marion General Hospital Foundation, Inc. Past Accepting new patients
Emergency Medicine Physicians of Franklin County, LTD Past Accepting new patients
Robert a. Norman, D.O., P.a. Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Marion Physician Billing LLC Past Accepting new patients

Locations

18865 State Road 54
Lutz, FL 33558
Phone (813) 413-6823

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536019200000",
    "number": "1679511802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18865 STATE ROAD 54 # 301",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335588201",
            "telephone_number": "813-459-7711",
            "fax_number": "813-235-4175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16734 IVY LAKE DR",
            "city": "ODESSA",
            "state": "FL",
            "postal_code": "335566020",
            "telephone_number": "813-459-7711",
            "fax_number": "813-235-4175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARR",
        "first_name": "J DAVID",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2018-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ZZ",
            "license": "PA9108698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHN",
            "last_name": "BARR",
            "middle_name": "DAVID",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Odessa, FL

Sources for this page

Verify at the official NPI Registry.