Novo Plastic Surgery LLC

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

ME99596 Issued in FL

Legal business name

NOVO PLASTIC SURGERY LLC

Practice address

5147 N 9TH Ave
Suite 203
Pensacola, FL 32504-8771

Phone

(904) 316-1515

NPI assigned

Mar 19, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Kyle Kit Shaddix, MD

Title

Manager

Phone

(904) 316-1515

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1426723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426723200000",
    "number": "1740674464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5147 N 9TH AVE",
            "address_2": "SUITE 203",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048771",
            "telephone_number": "904-316-1515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5147 N 9TH AVE",
            "address_2": "SUITE 203",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048771",
            "telephone_number": "904-316-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVO PLASTIC SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-19",
        "last_updated": "2015-03-19",
        "status": "A",
        "authorized_official_last_name": "SHADDIX",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "KIT",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "904-316-1515",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "FL",
            "license": "ME99596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northwest Florida Pathology LLC
• Northwest Florida Physicians Group, LLC
• Northwest Florida Surgical Center, LLC
• Naomi Kirkland Norton, D.M.D.
• Nova Millennium Healthcare, LLC
• Elizabeth Marie Nowak
• Tanzina Nowrin, MD
• Npoc LLC
• NSS-Alf Pensacola LLC
• Afua Ntiwa

• Plastic and Reconstructive Surgery Physician in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Plastic and Reconstructive Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2015; 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.