Excalibur Telemedical Services

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

EXCALIBUR TELEMEDICAL SERVICES

Doing business as

Excalibur Telemedical Services

Practice address

405 Waterford LN
Gulf Breeze, FL 32561-4872

Phone

(850) 982-9384

Fax

(850) 934-0711

NPI assigned

Apr 16, 2020

Last updated

Apr 16, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kim Landry, MDNPI 1851354609

Title

President/Ceo

Phone

(850) 982-9384

Specialties & licenses 2

Addresses

Other names 1

• Excalibur Telemedical Services Doing business as

Practitioners 1

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.

• Kim Landry, M D.

  • Emergency Medicine Physician
  • Pensacola, FL
  • NPI 1851354609
  NPD Authorized official

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

{
    "created_epoch": "1586995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586995200000",
    "number": "1982224259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 WATERFORD LN",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325614872",
            "telephone_number": "850-982-9384",
            "fax_number": "850-934-0711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 WATERFORD LN",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325614872",
            "telephone_number": "850-982-9384",
            "fax_number": "850-934-0711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCALIBUR TELEMEDICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-16",
        "last_updated": "2020-04-16",
        "certification_date": "2020-04-16",
        "status": "A",
        "authorized_official_last_name": "LANDRY",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "850-982-9384",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Excalibur Telemedical Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Emergency Medicine Physician in Gulf Breeze, FL
• Providers in Gulf Breeze, FL by specialty
• Emergency Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.