NPIMap

Organization Active NPI

West Florida Gulf Coast Primary Care

Doing business as Greater Gulf Coast Primary Care

  • General Practice Physician
  • Pensacola, FL
National Provider Identifier
1801109178
Registry record updated Jul 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
WEST FLORIDA GULF COAST PRIMARY CARE
Doing business as
Greater Gulf Coast Primary Care
Practice address
1921 E Nine Mile Rd
Pensacola, FL 32514-7747
Phone
(850) 479-4858
Fax
(850) 494-2260
NPI assigned
Jul 15, 2010
Last updated
Jul 15, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2010

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

Authorized official

Name
Jason K Harvey
Title
Executive Director
Phone
(850) 479-4858

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

1921 E Nine Mile Rd
Pensacola, FL 32514-7747

Mailing address

1921 E Nine Mile Rd
Pensacola, FL 32514-7747
Phone (850) 479-4858

Other identifiers 2

IdentifierTypeStateIssuer
98338OtherFLBCBS
001169200MedicaidFL

Other names 1

  • Greater Gulf Coast Primary Care Doing business as

National Provider Directory

National Provider Directory

Locations

1921 E Nine Mile Rd
Ste A
Pensacola, FL 32514
Phone (850) 479-4791

Practitioners & affiliated clinicians

Practitioners 4

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": "1279152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279152000000",
    "number": "1801109178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 E NINE MILE RD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325147747",
            "telephone_number": "850-479-4858",
            "fax_number": "850-494-2260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 E NINE MILE RD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325147747",
            "telephone_number": "850-479-4858",
            "fax_number": "850-494-2260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST FLORIDA GULF COAST PRIMARY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-15",
        "last_updated": "2010-07-15",
        "status": "A",
        "authorized_official_last_name": "HARVEY",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "850-479-4858"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "98338",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001169200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greater Gulf Coast Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 15, 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.