West Coast Surgical Group PLLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

ME62365 Issued in FL

Legal business name

WEST COAST SURGICAL GROUP PLLC

Practice address

5953 17TH Ave W
Bradenton, FL 34209-7836

Phone

(941) 746-8127

Fax

(941) 746-8127

NPI assigned

Feb 23, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Paige Koenig Pennebacker

Title

MD

Phone

(941) 761-0500

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1329955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516752000000",
    "number": "1679847529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14731",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342804731",
            "telephone_number": "941-545-4002",
            "fax_number": "941-748-6195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5953 17TH AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342097836",
            "telephone_number": "941-746-8127",
            "fax_number": "941-746-8127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST COAST SURGICAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-23",
        "last_updated": "2018-01-24",
        "status": "A",
        "authorized_official_last_name": "PENNEBACKER",
        "authorized_official_first_name": "PAIGE",
        "authorized_official_middle_name": "KOENIG",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "941-761-0500",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME62365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• West Coast - Southern Medical Service Inc
• West Coast Dental Partners
• West Coast OB/GYN
• West Coast Pediatrics
• West Coast Podiatry Center, Inc.
• West Florida Anesthesia Consultants, PA
• West Florida Anesthesia Trauma Services LLC
• West Florida Cardiology Network, LLC
• West Florida Carenow Urgent Care, LLC
• West Florida Physician Network, LLC

• Surgery Physician in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2018; 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.