WHITE-WILSON MEDICAL CENTER, P.A. (NPI# 1134267537) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134267537 |
| Entity Type | Organization |
| Organization Name | WHITE-WILSON MEDICAL CENTER, P.A. |
| Other Organization Name | WHITE-WILSON MED CTR-FWB FP DEPT |
| Practice Address |
1005 Mar Walt Dr Fp Department Fort Walton Beach FL 32547-6707 |
| Practice Telephone | 8508636600 |
| Practice Fax Number | 8508620977 |
| Mailing Telephone | 8508636600 |
| Mailing Fax Number | 8508620977 |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DOUGLAS W. RIGBY (PRESIDENT) |
| Authorized Official Telephone | 8508638131 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| White-Wilson Med Ctr-FWB FP Dept | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447474234 | White-wilson Medical Center, P.a. | Pediatrics | 2001 E. Highway 20, Pediatric Department, Niceville, FL 32578 | 2007-04-12 |
| 1013054469 | White-wilson Medical Center, P.a. | Family Medicine | 2001 E Highway 20, Family Practice Department, Niceville, FL 32578-8826 | 2007-02-01 |
| 1184761538 | White-wilson Medical Center, P.a. | Pediatrics | 990 Airport Rd, Pediatric Department, Destin, FL 32541-2820 | 2007-02-01 |
| 1518005917 | White-wilson Medical Center, P.a. | Pediatrics | 1005 Mar Walt Dr, Pediatric Department, Fort Walton Beach, FL 32547-6707 | 2007-02-01 |
| Street Address |
1005 MAR WALT DR FP DEPARTMENT |
| City | FORT WALTON BEACH |
| State | FL |
| Zip Code | 32547-6707 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174517627 | Michael Andrew Johnson | Physician Assistant | 1005 Mar Walt Dr, Internal Medicine Department, Fort Walton Beach, FL 32547-6707 | 2005-09-09 |
| 1023658408 | Katelyn Elaine Dye | Nurse Practitioner | 1005 Mar Walt Dr, Fort Walton Beach, FL 32547-6707 | 2020-01-13 |
| 1467988220 | Katrina Pendleton Borner | Nurse Practitioner | 1005 Mar Walt Dr, Fort Walton Beach, FL 32547-6707 | 2017-05-11 |
| 1992067383 | Irina Viktorovna Smith | Pediatrics | 1005 Mar Walt Dr, Fort Walton Beach, FL 32547-6707 | 2012-06-12 |
| 1114242781 | Leslie Marie Anderson | Dietitian, Registered | 1005 Mar Walt Dr, Fort Walton Beach, FL 32547-6707 | 2010-04-07 |
| 1518005917 | White-wilson Medical Center, P.a. | Pediatrics | 1005 Mar Walt Dr, Pediatric Department, Fort Walton Beach, FL 32547-6707 | 2007-02-01 |
| 1669410924 | Charles Joseph Clancy | Emergency Medicine | 1005 Mar Walt Dr, Immediate Care Department, Fort Walton Beach, FL 32547-6707 | 2006-06-02 |
| 1275519886 | Lawrence P King | Pediatrics | 1005 Mar Walt Dr, Pediatric Department, Fort Walton Beach, FL 32547-6707 | 2005-12-16 |
| 1336124098 | Harold Timothy Johnson | Physician Assistant | 1005 Mar Walt Dr, Family Medicine Department, Fort Walton Beach, FL 32547-6707 | 2005-12-14 |
| 1790760502 | Gilberto Luis Vigo | Internal Medicine | 1005 Mar Walt Dr, Internal Medicine Department, Fort Walton Beach, FL 32547-6707 | 2005-12-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255944955 | Theresa Ann Morvay | Behavior Technician | 419 Racetrack Rd Ne, Fort Walton Beach, FL 32547 | 2020-08-24 |
| 1588295422 | Emily Ann Glossop | Nurse Practitioner | 930 Mar Walt Drive C, Fort Walton Beach, FL 32547 | 2020-01-29 |
| 1225669443 | Elizabeth Rogers Nagengast | Physician Assistant | 930 Mar Walt Drive, Unit C, Fort Walton Beach, FL 32547 | 2020-01-27 |
| 1497254791 | Carmen Alston | Nurse Practitioner | 930 Mar Walt Dr C, Fort Walton Beach, FL 32547 | 2018-02-02 |
| 1871004960 | Center for Neuropsychological Services Cns | Clinical Neuropsychologist | 1817 Lewis Turner Blvd, Fort Walton Beach, FL 32547 | 2017-10-17 |
| 1194235648 | Robin Wray | Speech-Language Pathologist | 930 Mar Walt Dr D, Fort Walton Beach, FL 32547 | 2017-10-10 |
| 1285007989 | Dynamic Pain & Wellness Pllc | Pain Medicine | 930 Marwalt Drive, Suite B and C, Fort Walton Beach, FL 32547 | 2015-11-04 |
| 1013392810 | Terry Abbott | Social Worker | 648 Overbrook Dr, Fort Walton Beach, FL 32547 | 2015-07-22 |
| 1083024673 | Emily Lohr | Physical Therapy Assistant | 2000 Principle Ln, Ft. Walton Beach, FL 32547 | 2014-05-05 |
| 1831526102 | Laurie Ann Schweppe | Nurse Practitioner | 1005 Mar Walt Drivve, Snf Hospitalist Department, Fort Walton Beach, FL 32547 | 2013-10-02 |
| Find all providers in zip 32547 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023295821 | Gerald M Hollingsworth | Family Medicine | 203 Patrick Dr, Fort Walton Beach, FL 32547-1496 | 2008-01-24 |
| 1609078468 | Francisca Marquita Ward | Family Medicine | 1185 Jamescross Ct, Fort Walton Beach, FL 32547-7168 | 2007-06-04 |
| 1245273267 | Chris George Pappas | Family Medicine | 319 Green Acres Rd, Suite 101, Fort Walton Beach, FL 32547 | 2006-06-14 |
| 1972555720 | Darren L. Cook | Family Medicine | 131 Magnolia Ave Se, Fort Walton Beach, FL 32548-7266 | 2006-05-17 |
| 1346202686 | Robert V. Siegel | Family Medicine | 345 Miracle Strip Pkwy Sw, Fort Walton Beach, FL 32548-5210 | 2006-04-03 |
| 1265428171 | Christopher Peter Paulson | Family Medicine | 319 Green Acres Rd Ste 101, Fort Walton Beach, FL 32547 | 2005-09-26 |
| 1366000432 | Bridgeway Health Clinics, Inc. | Family Medicine | 137 Hospital Dr Ne, Fort Walton Beach, FL 32548-5063 | 2019-06-03 |
| 1184142440 | Brandy Lee Gessendorf | Family Medicine | 1000 Mar Walt Dr, Fort Walton Beach, FL 32547-6708 | 2017-09-06 |
| 1982054391 | Grant Zachary | Family Medicine | 319 Green Acres Rd Ste 101, Fort Walton Beach, FL 32547-1170 | 2016-06-16 |
| 1972986669 | Peter Kozlowski Md Pa | Family Medicine | 2010 Lewis Turner Blvd, Fort Walton Beach, FL 32547-1352 | 2015-06-30 |
| Find all providers in FORT WALTON BEACH | ||||
| City | FORT WALTON BEACH |
| Zip Code | 32547 |
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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.