NPIMap

Organization Active NPI

Baycare Medical Group Pediatric Walk-in, LLC

  • Pediatrics Physician
  • Tampa, FL
National Provider Identifier
1679724488
Registry record updated Jan 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
BAYCARE MEDICAL GROUP PEDIATRIC WALK-IN, LLC
Practice address
4902 Eisenhower Blvd
Suite 300
Tampa, FL 33634-6310
Phone
(813) 636-2044
Fax
(813) 321-6998
NPI assigned
Oct 10, 2008
Last updated
Jan 6, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
BAYCARE MEDICAL GROUP, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 6, 2017

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

Authorized official

Name
Mr. Tommy Inzena
Title
President/Ceo
Phone
(813) 636-2044

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X
Pediatrics Physician 208000000X Primary

Addresses

Primary practice location

4902 Eisenhower Blvd
Suite 300
Tampa, FL 33634-6310

Mailing address

PO Box 743409
Atlanta, GA 30374-3409
Phone (727) 532-0002

National Provider Directory

National Provider Directory
Tax ID family
Baycare Medical Group Pediatric Walk-in Care LLC2 organizations share this tax ID, including this one
Part of
Morton Plant Mease Primary Care Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 159

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.

View all 159

NPI Registry JSON

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

{
    "created_epoch": "1223596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483660800000",
    "number": "1679724488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743409",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743409",
            "telephone_number": "727-532-0002",
            "fax_number": "727-532-1325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4902 EISENHOWER BLVD",
            "address_2": "SUITE 300",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336346310",
            "telephone_number": "813-636-2044",
            "fax_number": "813-321-6998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYCARE MEDICAL GROUP PEDIATRIC WALK-IN, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BAYCARE MEDICAL GROUP, INC",
        "enumeration_date": "2008-10-10",
        "last_updated": "2017-01-06",
        "status": "A",
        "authorized_official_last_name": "INZENA",
        "authorized_official_first_name": "TOMMY",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "813-636-2044",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 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.