NPIMap

Organization Active NPI

Baycare Medical Group Inc

  • Family Medicine Physician
  • Clearwater, FL
National Provider Identifier
1821661661
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BAYCARE MEDICAL GROUP INC
Practice address
3251 N McMullen Booth Rd Ste 103
Clearwater, FL 33761-2022
Phone
(727) 725-1003
Fax
(727) 635-7864
NPI assigned
Jul 20, 2021
Last updated
Jul 20, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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

Authorized official

Name
Lynda Gorken
Title
VP, PFS
Phone
(727) 281-9202

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Internal Medicine Physician 207R00000X NU

Addresses

Primary practice location

3251 N McMullen Booth Rd Ste 103
Clearwater, FL 33761-2022

Mailing address

2995 Drew St FL 3
Clearwater, FL 33759-3012
Phone (727) 281-9390

Other names 1

  • Countryside II Other name

National Provider Directory

National Provider Directory
Tax ID family
Morton Plant Family Car202 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

3251 N McMullen Booth Rd
Ste 103
Clearwater, FL 33761
Phone (727) 725-1003

NPI Registry JSON

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

{
    "created_epoch": "1626739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626739200000",
    "number": "1821661661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2995 DREW ST FL 3",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337593012",
            "telephone_number": "727-281-9390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3251 N MCMULLEN BOOTH RD STE 103",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337612022",
            "telephone_number": "727-725-1003",
            "fax_number": "727-635-7864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYCARE MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-20",
        "last_updated": "2021-07-20",
        "certification_date": "2021-06-23",
        "status": "A",
        "authorized_official_last_name": "GORKEN",
        "authorized_official_first_name": "LYNDA",
        "authorized_official_title_or_position": "VP, PFS",
        "authorized_official_telephone_number": "727-281-9202"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Countryside II",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; 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.