Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Basil D. Fossum, M.D. PA

Urology Physician in Fort Walton Beach, FL · enumerated 2021 · authorized official Basil Fossum MD PA, Owner.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1154911527

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Registry record

Entity type Organization (Type 2)

Legal business name Basil D. Fossum, M.D. PA

Other name <Unavail>

Practice address 914 Mar Walt Dr Ste B, Fort Walton Beach, FL, 32547

Phone (850) 226-6572

Fax (850) 862-8564

Enumeration date Jan 20, 2021

Last updated in NPPES May 22, 2025

Taxonomy & classification

208800000X Urology Physician Allopathic & Osteopathic Physicians Primary

Authorized official

Name Basil Fossum MD PA

Title Owner

Phone (850) 862-2555

Other identifiers

Identifier	Type	State	Issuer
ME53505	Other	FL	MEDICAL LICENSE

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2025-05-22. Verify at npiregistry.cms.hhs.gov.

Where is Basil D. Fossum, M.D. PA located?

The practice location on file with NPPES is in Fort Walton Beach, FL.

Providers at this address

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Basil D. Fossum, M.D., F.A.C.S. Urology Physician · Fort Walton Beach, FL NPI 1235326026

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2025-05-22.