Individual provider Active NPI

Bascom Clarence Raney

  • Family Medicine Physician
  • Pensacola, FL
National Provider Identifier
1720083876
Registry record updated May 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME0051114 Issued in FL
Practice address
9400 University Pkwy
Suite 409
Pensacola, FL 32514-5752
Phone
(850) 208-6160
NPI assigned
Jun 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME0051114 FL Primary

Addresses

Primary practice location

9400 University Pkwy
Suite 409
Pensacola, FL 32514-5752

Mailing address

245 W Airport Blvd
Pensacola, FL 32505-2254

Other identifiers 6

IdentifierTypeStateIssuer
04161OtherFLBLUE CROSS FLORIDA
660034400OtherFLRURAL HEALTH (MEDICAL)
010024345OtherFLRAILROAD MEDICARE
59064837OtherALBLUE CROSS ALABAMA
103864OtherCAHABE GBA MEDICARE
046121100MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100811000237 FL Practitioner - Family Practice 6901930080 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Medical Group LLC CurrentSince May 5, 2014 Accepting new patients
Jay Hospital, Inc. CurrentSince Jul 1, 1987 Accepting new patients
Jay Hospital, Inc. CurrentSince Jul 1, 1987 Accepting new patients
Baptist Medical Group LLC Family Medicine CurrentSince May 5, 2014 Accepting new patients
Bascom Clarence Raney PastSince Jul 1, 1987 Accepting new patients

Locations

8401 N Century Blvd
Century, FL 32535
Phone (850) 256-5314

14114 Alabama St
Jay, FL 32565
Phone (850) 675-8000

245 W Airport Blvd
Pensacola, FL 32505

9400 University Pkwy
Ste 409
Pensacola, FL 32514
Phone (850) 994-7256

9400 University Pkwy
Ste 210
Pensacola, FL 32514
Phone (448) 227-4240

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400457600000",
    "number": "1720083876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 W AIRPORT BLVD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325052254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9400 UNIVERSITY PKWY",
            "address_2": "SUITE 409",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325145752",
            "telephone_number": "850-208-6160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANEY",
        "first_name": "BASCOM",
        "middle_name": "CLARENCE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2014-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0051114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS FLORIDA",
            "identifier": "04161",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RURAL HEALTH (MEDICAL)",
            "identifier": "660034400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "010024345",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS ALABAMA",
            "identifier": "59064837",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAHABE GBA MEDICARE",
            "identifier": "103864",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046121100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.