PENSACOLA NEPHROLOGY PA (NPI# 1033167374) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033167374 |
| Entity Type | Organization |
| Organization Name | PENSACOLA NEPHROLOGY PA |
| Practice Address |
550 Redstone Ave W Suite 200 Crestview FL 32536-6428 |
| Mailing Address |
1717 North E St Suite 403 Suite 403 Pensacola FL 32501-6364 |
| Practice Telephone | 8508622385 |
| Practice Fax Number | 8508620482 |
| Mailing Telephone | 8504444700 |
| Mailing Fax Number | 8504348144 |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2008-04-23 |
| Authorized Official Name | MRS. PATRICIA BREELAND (ADMINISTRATOR) |
| Authorized Official Telephone | 8504444700 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 256870501 | 05 | |
| FL | 256870503 | 05 | |
| FL | 256870502 | 05 | |
| FL | 256870506 | 05 | |
| FL | 256870508 | 05 | |
| FL | 256870500 | 05 | |
| FL | 256870504 | 05 | |
| FL | 256870507 | 05 | |
| FL | 256870505 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548204357 | Pensacola Nephrology Pa | Specialist | 6001 Industrial Blvd, Century, FL 32535-3312 | 2006-06-15 |
| 1558304519 | Pensacola Nephrology Pa | Specialist | 5934 Berryhill Medical Park Dr, Suite 1, Milton, FL 32570 | 2006-06-14 |
| 1871535955 | Pensacola Nephrology Pa | Specialist | 925 Mar Walt Dr, Suite 1, Ft Walton Beach, FL 32547-6759 | 2006-06-12 |
| 1467495424 | Pensacola Nephrology Pa | Specialist | 5149 N 9th Ave, Suite G35, Pensacola, FL 32504-8756 | 2006-06-14 |
| 1245273242 | Pensacola Nephrology Pa | Specialist | 5401 Corporate Woods Dr, Suite 850, Pensacola, FL 32504-8984 | 2006-06-14 |
| 1477501153 | Pensacola Nephrology Pa | Specialist | 9400 University Pkwy, Suite 109, Pensacola, FL 32514-5752 | 2006-05-04 |
| 1518969765 | Pensacola Nephrology Pa | Internal Medicine | 1619 Creighton Rd Ste 1, Pensacola, FL 32504-7152 | 2005-06-01 |
| Street Address |
550 REDSTONE AVE W SUITE 200 |
| City | CRESTVIEW |
| State | FL |
| Zip Code | 32536-6428 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730161126 | Anne Denys | Orthopaedic Surgery | 550 Redstone Ave W, Ste 370, Crestview, FL 32536-6428 | 2005-11-19 |
| 1033642350 | Charles Eugene Hewett IIi | Specialist/Technologist | 550 Redstone Ave W, Crestview, FL 32536-6428 | 2017-04-04 |
| 1740639731 | Jung Hyun Koh | Nurse Practitioner | 550 Redstone Ave W, Suite 200, Crestview, FL 32536-6428 | 2016-06-09 |
| 1942441795 | Kara O Brooks | Family Medicine | 550 Redstone Ave W, Suite 200, Crestview, FL 32536-6428 | 2009-03-07 |
| 1477738896 | North Okaloosa Clinic Corp | Durable Medical Equipment & Medical Supplies | 550 Redstone Ave W, Ste. 370, Crestview, FL 32536-6428 | 2008-01-03 |
| 1851570071 | Crestview Hospital Corporation | Orthopaedic Surgery | 550 Redstone Ave W, Suite 370, Crestview, FL 32536-6428 | 2007-10-25 |
| 1154512358 | Gary Charles Perez | Physician Assistant | 550 Redstone Ave W, Suite 370, Crestview, FL 32536-6428 | 2007-08-05 |
| 1528258159 | Janet S Hamby | Obstetrics & Gynecology | 550 Redstone Ave W, Suite 450, Crestview, FL 32536-6432 | 2007-07-30 |
| 1033320312 | Gregory Coates | Obstetrics & Gynecology | 550 Redstone Ave W, Suite 470, Crestview, FL 32536-6428 | 2007-05-25 |
| 1609090158 | Marcello A Borzatta Md Pa | Surgery | 550 Redstone Ave W, Suite 430, Crestview, FL 32536-6428 | 2007-04-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831684901 | Eva Maria I Matute | Adult Companion | 6050 Trestle St, Crestview, FL 32536 | 2018-06-29 |
| 1669989232 | Lauren Estep Flowers | Physician Assistant | 550 Redstone Ave W Ste 370, Crestview, FL 32536 | 2018-01-04 |
| 1427444868 | Jessie Huisken | Social Worker | 5890 Saratoga Dr, Crestview, FL 32536 | 2015-04-13 |
| 1679846166 | John D. Carlson Md | Specialist | 492 North Wilson Street, Crestview, FL 32536 | 2012-02-15 |
| 1154609691 | Alternative Living, Inc. | Assisted Living Facility | 603 North Pearl Street, Crestview, FL 32536 | 2011-08-02 |
| 1487821526 | Michael G Foley Md Pa | Internal Medicine | 524 James Lee Blvd W, Crestview, FL 32536 | 2008-05-08 |
| 1184805830 | Advanced Family Medicine Clinic Inc | Family Medicine | 327 Medcrest Drive, Unit A, Crestview, FL 32536 | 2007-11-23 |
| 1164631511 | Caring Hearts Pediatric Extended Care Center, Inc | Clinic/Center | 380 Medcrest Dr, Crestview, FL 32536 | 2007-05-22 |
| 1669697751 | Crestview Chiropractic Clinic, Inc. | Chiropractor | 1078 S. Ferdon Boulevard, Suite A, Crestview, FL 32536 | 2007-04-16 |
| 1457492886 | Roy M Nakaiye | Dentist | 222 Cedar Ave, Crestview, FL 32536 | 2007-02-09 |
| Find all providers in zip 32536 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811250749 | Maria Rodriguez | Specialist | 6201 Flash Ln, Crestview, FL 32536-4367 | 2012-06-15 |
| 1679846166 | John D. Carlson Md | Specialist | 492 North Wilson Street, Crestview, FL 32536 | 2012-02-15 |
| 1831237460 | Stephen Arnold Schwartz | Specialist | 1408 Grandview Dr, Crestview, FL 32539-8519 | 2007-02-04 |
| 1932131596 | John Dale Carlson | Specialist | 492 N Wilson St, Crestview, FL 32536-3442 | 2006-07-06 |
| 1346295615 | Anesthesia and Pain Consultants, Pa | Specialist | 634 Riverwood Dr, Crestview, FL 32536-5008 | 2006-05-24 |
| 1245280858 | Shijun Pan | Specialist | 535 S Ferdon Blvd Ste C, Crestview, FL 32536-4446 | 2006-05-12 |
| 1770572745 | Alfred Cardet | Specialist | 550 W Redstone Ave, Suite300, Crestview, FL 32536-6429 | 2005-10-20 |
| 1649262650 | Marty P Gagliardi | Specialist | 127 E Redstone Ave, Suite B, Crestview, FL 32539-5358 | 2005-08-16 |
| 1700119443 | Bluewater Orthopedics, P.a. | Specialist | 120 E Redstone Ave, Suite B, Crestview, FL 32539-5370 | 2009-09-14 |
| 1063680528 | Okaloosa Pulmonary & Sleep Medicine Clinic | Specialist | 131 E Redstone Ave, Suite 105, Crestview, FL 32539-5326 | 2008-02-18 |
| Find all providers in CRESTVIEW | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.