Organization Active NPI

Bahri Orthopedics & Sports Medicine Clinic, P.L.

  • Orthopaedic Surgery Physician
  • Jacksonville, FL
National Provider Identifier
1962598623
Registry record updated May 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
BAHRI ORTHOPEDICS & SPORTS MEDICINE CLINIC, P.L.
Practice address
6100 Kennerly Road
Suite 101
Jacksonville, FL 32216
Phone
(904) 739-0050
NPI assigned
Oct 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2015

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

Authorized official

Name
Ms. Lori Ball Bahri
Title
Administrator
Phone
(904) 739-0050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

6100 Kennerly Road
Suite 101
Jacksonville, FL 32216

Mailing address

6100 Kennerly Road
Suite 101
Jacksonville, FL 32216
Phone (904) 739-0050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040226000105 FL Part B Supplier - Clinic/Group Practice 8527954510 Receives reassigned benefits from 4 practitioners
Practice locations: Jacksonville, FL

National Provider Directory

National Provider Directory

Locations

2545 Riverside Ave
Jacksonville, FL 32204
Phone (904) 388-1009

580 W 8th St
Ste 608
Jacksonville, FL 32209
Phone (904) 359-8800

1045 Riverside Ave
Ste 110
Jacksonville, FL 32204
Phone (904) 264-0770

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430956800000",
    "number": "1962598623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 KENNERLY ROAD",
            "address_2": "SUITE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32216",
            "telephone_number": "904-739-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 KENNERLY ROAD",
            "address_2": "SUITE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32216",
            "telephone_number": "904-739-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAHRI ORTHOPEDICS & SPORTS MEDICINE CLINIC, P.L.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2015-05-07",
        "status": "A",
        "authorized_official_last_name": "BALL BAHRI",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "904-739-0050",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2015; 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.