NPIMap

Organization Active NPI

Bayer Neurobehavioral Center, PLLC

  • Clinical Neuropsychologist
  • Fort Walton Beach, FL
National Provider Identifier
1720470255
Registry record updated Aug 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PY9214 Issued in FL
Legal business name
BAYER NEUROBEHAVIORAL CENTER, PLLC
Practice address
3 Vine Ave NE
Fort Walton Beach, FL 32548-5069
Phone
(850) 226-7666
Fax
(850) 266-7499
NPI assigned
Feb 20, 2015
Last updated
Aug 23, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2016

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

Authorized official

Name
Dr. Zachary C Bayer, PSYDNPI 1619296555
Title
Clinical Neuropsychologist
Phone
(850) 226-7666

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PY9214 FL Primary
Clinical Psychologist 103TC0700X PY9440 FL

Addresses

Primary practice location

3 Vine Ave NE
Fort Walton Beach, FL 32548-5069

Mailing address

3 Vine Ave NE
Fort Walton Beach, FL 32548-5069
Phone (850) 226-7666

Other names 1

  • Zachary C. Bayer, PsyD., LLC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150408001032 FL Part B Supplier - Clinic/Group Practice 4981922747 Receives reassigned benefits from 9 practitioners
Practice locations: Fort Walton Beach, FL

National Provider Directory

National Provider Directory

Locations

203 Hollywood Blvd NE
Fort Walton Beach, FL 32548
Phone (850) 226-7666

3 Vine Ave NE
Ft Walton Bch, FL 32548
Phone (850) 226-7666

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1424390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471910400000",
    "number": "1720470255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 VINE AVE NE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325485069",
            "telephone_number": "850-226-7666",
            "fax_number": "850-266-7499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 VINE AVE NE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325485069",
            "telephone_number": "850-226-7666",
            "fax_number": "850-266-7499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYER NEUROBEHAVIORAL CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-20",
        "last_updated": "2016-08-23",
        "status": "A",
        "authorized_official_last_name": "BAYER",
        "authorized_official_first_name": "ZACHARY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CLINICAL NEUROPSYCHOLOGIST",
        "authorized_official_telephone_number": "850-226-7666",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY9214",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY9440",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Zachary C. Bayer, PsyD., LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Fort Walton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.