NPIMap

Organization Active NPI

Santa Rosa Gastroenterology

  • Gastroenterology Physician
  • Milton, FL
National Provider Identifier
1790956472
Registry record updated Dec 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
SANTA ROSA GASTROENTEROLOGY
Practice address
5992 Berryhill Rd
Suite 201
Milton, FL 32570-1013
Phone
(850) 626-9626
Fax
(850) 626-9606
NPI assigned
Mar 20, 2008
Last updated
Dec 20, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2010

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

Authorized official

Name
Keri A Rusynyk
Title
Office Manager
Phone
(850) 748-4420

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X NU Primary

Addresses

Primary practice location

5992 Berryhill Rd
Suite 201
Milton, FL 32570-1013

Mailing address

5992 Berryhill Rd
Suite 201
Milton, FL 32570-1013
Phone (850) 626-9626

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1205971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292803200000",
    "number": "1790956472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5992 BERRYHILL RD",
            "address_2": "SUITE 201",
            "city": "MILTON",
            "state": "FL",
            "postal_code": "325701013",
            "telephone_number": "850-626-9626",
            "fax_number": "850-626-9606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5992 BERRYHILL RD",
            "address_2": "SUITE 201",
            "city": "MILTON",
            "state": "FL",
            "postal_code": "325701013",
            "telephone_number": "850-626-9626",
            "fax_number": "850-626-9606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA ROSA GASTROENTEROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-20",
        "last_updated": "2010-12-20",
        "status": "A",
        "authorized_official_last_name": "RUSYNYK",
        "authorized_official_first_name": "KERI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "850-748-4420"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2010; 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.