CGM Diabetic Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

CGM DIABETIC SUPPLY

Practice address

4400 N Federal Hwy Ste 210-49
Boca Raton, FL 33431-5187

Phone

(561) 570-5915

NPI assigned

May 11, 2020

Organization subpart

No

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

Authorized official

Name

William Robert Baylis

Title

Authorized Member

Phone

(561) 570-5915

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1589155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589155200000",
    "number": "1821610122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1271 SW 13TH DR",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334865364",
            "telephone_number": "561-299-6893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 N FEDERAL HWY STE 210-49",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334315187",
            "telephone_number": "561-570-5915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CGM DIABETIC SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-11",
        "last_updated": "2020-05-11",
        "certification_date": "2020-05-11",
        "status": "A",
        "authorized_official_last_name": "BAYLIS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "AUTHORIZED MEMBER",
        "authorized_official_telephone_number": "561-570-5915"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2020; 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.