NPIMap

Organization Active NPI

Baycare Medical Group Pediatric Walk-in Care LLC

  • Pediatrics Physician
  • Lutz, FL
National Provider Identifier
1861850117
Registry record updated Feb 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
BAYCARE MEDICAL GROUP PEDIATRIC WALK-IN CARE LLC
Practice address
4211 Van Dyke Rd
Suite 100
Lutz, FL 33558-8005
Phone
(813) 960-1813
Fax
(813) 443-8172
NPI assigned
Feb 2, 2016
Last updated
Feb 2, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2016

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

Authorized official

Name
Mr. Kevin L Corrigan
Title
Cao
Phone
(727) 532-0002

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X FL Primary

Addresses

Primary practice location

4211 Van Dyke Rd
Suite 100
Lutz, FL 33558-8005

Mailing address

PO Box 743409
Atlanta, GA 30374-3409
Phone (727) 532-0002

National Provider Directory

National Provider Directory
Tax ID family
Baycare Medical Group Pediatric Walk-in Care LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4211 Van Dyke Rd
Ste 100
Lutz, FL 33558
Phone (813) 960-1813

Practitioners & affiliated clinicians

Practitioners 148

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.

View all 148

NPI Registry JSON

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

{
    "created_epoch": "1454371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454371200000",
    "number": "1861850117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743409",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743409",
            "telephone_number": "727-532-0002",
            "fax_number": "727-532-1325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 VAN DYKE RD",
            "address_2": "SUITE 100",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335588005",
            "telephone_number": "813-960-1813",
            "fax_number": "813-443-8172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYCARE MEDICAL GROUP PEDIATRIC WALK-IN CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-02",
        "last_updated": "2016-02-02",
        "status": "A",
        "authorized_official_last_name": "CORRIGAN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CAO",
        "authorized_official_telephone_number": "727-532-0002",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutz, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2016; 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.