Jay Sourbeer, M.D.

Primary specialty

Military Health Care ProviderTaxonomy code 171000000X

License

ME58815 Issued in FL

Practice address

321 Bullfinch Road
Navy Experimental Diving Unit
Panama City, FL 32407-7015

Phone

(850) 230-3148

NPI assigned

Mar 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491177600000",
    "number": "1699744565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 BULLFINCH ROAD",
            "address_2": "NAVY EXPERIMENTAL DIVING UNIT",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324077015",
            "telephone_number": "850-230-3148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 BULLFINCH ROAD",
            "address_2": "NAVY EXPERIMENTAL DIVING UNIT",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324077015",
            "telephone_number": "850-230-3148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOURBEER",
        "first_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2017-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "FL",
            "license": "ME58815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Military Health Care Provider in Panama City, FL
• Providers in Panama City, FL by specialty
• Military Health Care Provider in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.