Active NPI
Beachside Medical Group LLC
- Neonatal-Perinatal Medicine Physician
- Pensacola, FL
National Provider Identifier
1740078799
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- Legal business name
- BEACHSIDE MEDICAL GROUP LLC
- Practice address
- 8383 N Davis Hwy
Pensacola, FL 32514-6039 - Phone
- (850) 473-0100
- Fax
- (850) 473-0500
- NPI assigned
- Apr 29, 2025
- Organization subpart
- Yes
- Parent organization
- BEACHSIDE MEDICAL GROUP LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Evie Duckworth
- Title
- Credentialing Manager
- Phone
- (850) 478-1312
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal-Perinatal Medicine Physician | 2080N0001X | Primary |
Addresses
Primary practice location
8383 N Davis Hwy
Pensacola, FL 32514-6039
Mailing address
4951 Grande Dr
Pensacola, FL 32504-8965
Phone (850) 473-0100
National Provider Directory
National Provider Directory- Tax ID family
- Beachside Medical Group LLC
- Part of
- Beachside Medical Group LLC
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Neonatal-Perinatal Medicine Physician
- Pensacola, FL
- NPI 1144022146
-
- Neonatal-Perinatal Medicine Physician
- Pensacola, FL
- NPI 1568250512
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
- Neonatal-Perinatal Medicine Physician
- Pensacola, FL
- NPI 1144022146
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1745884800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1745884800000",
"number": "1740078799",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4951 GRANDE DR",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325048965",
"telephone_number": "850-473-0100",
"fax_number": "850-473-0500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8383 N DAVIS HWY",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325146039",
"telephone_number": "850-473-0100",
"fax_number": "850-473-0500"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BEACHSIDE MEDICAL GROUP LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "BEACHSIDE MEDICAL GROUP LLC",
"enumeration_date": "2025-04-29",
"last_updated": "2025-04-29",
"certification_date": "2025-04-29",
"status": "A",
"authorized_official_last_name": "DUCKWORTH",
"authorized_official_first_name": "EVIE",
"authorized_official_title_or_position": "CREDENTIALING MANAGER",
"authorized_official_telephone_number": "850-478-1312"
},
"taxonomies": [
{
"code": "2080N0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pensacola, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.