NPIMap

Organization Active NPI

Gastroenterology Associates of Pensacola PA

  • Gastroenterology Physician
  • Pensacola, FL
National Provider Identifier
1891768123
Registry record updated Feb 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
GASTROENTEROLOGY ASSOCIATES OF PENSACOLA PA
Practice address
5147 N 9TH Ave Ste 311
Pensacola, FL 32504-8770
Phone
(850) 477-2597
Fax
(850) 478-7941
NPI assigned
Feb 8, 2006
Last updated
Feb 28, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2018

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

Authorized official

Name
Mr. Stephen Dunn
Title
Administrator/Cfo
Phone
(850) 474-8988

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

5147 N 9TH Ave Ste 311
Pensacola, FL 32504-8770

Mailing address

4828 N Davis Hwy
Pensacola, FL 32503-2341
Phone (850) 477-8109

Other identifiers 5

IdentifierTypeStateIssuer
254428802MedicaidFL
0176OtherFLHEALTH OPTIONS
529201330MedicaidAL
21821AOtherFLBCBS OF FLORIDA
CM1536OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040726000423 FL Part B Supplier - Clinic/Group Practice 2365422664 Receives reassigned benefits from 122 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Navarre, FL; Pensacola, FL; Pace, FL; Milton, FL; Jay, FL; Gulf Breeze, FL; Crestview, FL
O20041027000186 AL Part B Supplier - Clinic/Group Practice 2365422664 Receives reassigned benefits from 11 practitioners
3 other NPIs on this enrollment
Practice locations: Atmore, AL; Brewton, AL; Foley, AL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 29

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 29

NPI Registry JSON

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519776000000",
    "number": "1891768123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4828 N DAVIS HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032341",
            "telephone_number": "850-477-8109",
            "fax_number": "850-476-5313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5147 N 9TH AVE STE 311",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048770",
            "telephone_number": "850-477-2597",
            "fax_number": "850-478-7941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTROENTEROLOGY ASSOCIATES OF PENSACOLA PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-08",
        "last_updated": "2018-02-28",
        "status": "A",
        "authorized_official_last_name": "DUNN",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "ADMINISTRATOR/CFO",
        "authorized_official_telephone_number": "850-474-8988",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "254428802",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH OPTIONS",
            "identifier": "0176",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529201330",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FLORIDA",
            "identifier": "21821A",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CM1536",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Feb 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.