Active NPI
Rickey J Viator, M.D.
- Pediatrics Physician
- Santa Rosa Beach, FL
National Provider Identifier
1689601338
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME45069
- Practice address
- 23 Mack Bayou Loop
Suite 200
Santa Rosa Beach, FL 32459-2604 - Phone
- (850) 278-3920
- NPI assigned
- Jun 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME45069 | FL | Primary |
Addresses
Primary practice location
23 Mack Bayou Loop
Suite 200
Santa Rosa Beach, FL 32459-2604
Mailing address
PO Box 2699
Pensacola, FL 32513-2699
Phone (850) 475-4500
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09135 | Other | FL | BCBS |
| 061248100 | Medicaid | FL | |
| 101554 | Other | FL | AVMED |
| P00379114 | Other | FL | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268784000000",
"number": "1689601338",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2699",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325132699",
"telephone_number": "850-475-4500",
"fax_number": "850-475-4619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23 MACK BAYOU LOOP",
"address_2": "SUITE 200",
"city": "SANTA ROSA BEACH",
"state": "FL",
"postal_code": "324592604",
"telephone_number": "850-278-3920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIATOR",
"first_name": "RICKEY",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-27",
"last_updated": "2010-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME45069",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "09135",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "061248100",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AVMED",
"identifier": "101554",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00379114",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Rosa Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.