NORTHWEST FLORIDA WOMENS CANCER CARE LLC (NPI# 1710172416) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710172416 |
| Entity Type | Organization |
| Organization Name | NORTHWEST FLORIDA WOMENS CANCER CARE LLC |
| Practice Address |
1032 Mar Walt Dr Suite 250 Fort Walton Beach FL 32547-6661 |
| Practice Telephone | 8508622021 |
| Mailing Telephone | 8508622021 |
| Enumeration Date | 2007-09-06 |
| Last Update Date | 2008-06-11 |
| Authorized Official Name | MICKEY PICKLER (VP) |
| Authorized Official Telephone | 8508622021 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| Street Address |
1032 MAR WALT DR SUITE 250 |
| City | FORT WALTON BEACH |
| State | FL |
| Zip Code | 32547-6661 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609872688 | John Robert Brent | Surgery | 1032 Mar Walt Dr, Ste 220, Fort Walton Beach, FL 32547-6645 | 2005-06-23 |
| 1275873275 | Timothy M Bradley,md Sc | Plastic Surgery | 1032 Mar Walt Dr, Suite 240, Fort Walton Beach, FL 32547-6661 | 2013-02-27 |
| 1205175635 | Barnett Facial Plastic & Reconstructive Surgery, Pa. | Otolaryngology | 1032 Mar Walt Dr, Suite 100, Fort Walton Beach, FL 32547-6661 | 2013-02-05 |
| 1790912269 | Northwest Florida Multispecialty Physicians LLC | Neurological Surgery | 1032 Mar Walt Dr, Suite 250, Fort Walton Beach, FL 32547-6661 | 2009-06-11 |
| 1679762611 | John R. Brent Md Pa | Specialist | 1032 Mar Walt Dr, Suite 220, Fort Walton Beach, FL 32547-6661 | 2007-10-16 |
| 1497823942 | Inna Victorovna Martire | Physician Assistant | 1032 Mar Walt Dr, Fort Walton Beach, FL 32547-6645 | 2006-12-01 |
| 1912928896 | Ft Walton Beach Internal Medicine LLC | Internal Medicine | 1032 Mar Walt Dr, Suite 230, Fort Walton Beach, FL 32547-6645 | 2006-07-23 |
| 1295769263 | Beach Orthopaedic & Sports Medicine Clinic, Pa | Orthopaedic Surgery | 1032 Mar Walt Dr, Suite 210, Fort Walton Beach, FL 32547-6645 | 2006-07-10 |
| 1831122803 | Kenneth Robert Ellison | Physician Assistant | 1032 Mar Walt Dr, Suite 250, Fort Walton Beach, FL 32547-6661 | 2006-07-10 |
| 1265477574 | Emerald Coast Ear, Nose, Throat & Allergies, P.a. | Health Maintenance Organization | 1032 Mar Walt Dr, Suite 100, Fort Walton Beach, FL 32547-6645 | 2006-06-19 |
| 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 | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104055599 | Diana Decotis Smith | Obstetrics & Gynecology | 928 Mar Walt Dr Ste 201, Fort Walton Beach, FL 32547-6706 | 2009-07-07 |
| 1518901479 | Donald William Whitaker | Obstetrics & Gynecology | 924 Mar Walt Dr, Fort Walton Beach, FL 32547-6706 | 2006-06-15 |
| 1144261082 | Stephanie Leemhuis Caywood | Obstetrics & Gynecology | 928e Mar Walt Dr Ste 201, Fort Walton Beach, FL 32547-6754 | 2006-06-10 |
| 1104818111 | Kathryn Anne Stevens | Obstetrics & Gynecology | 1703 Lewis Turner Blvd, Fort Walton Beach, FL 32547-1221 | 2005-08-16 |
| 1194000927 | Rosemarie M Schultz | Obstetrics & Gynecology | 221 Hospital Dr Ne, Fort Walton Beach, FL 32548-5066 | 2011-10-12 |
| 1568785277 | Donald W Whitaker Md Pa | Obstetrics & Gynecology | 924 Mar Walt Dr, Fort Walton Beach, FL 32547-6706 | 2010-03-09 |
| 1407083884 | Genesis Obgyn Pa | Obstetrics & Gynecology | 1025 Beal Pkwy Nw, Fort Walton Beach, FL 32547-1446 | 2009-06-12 |
| 1447403134 | Michael H. Hennessey, Md, Pa | Obstetrics & Gynecology | 907 Mar Walt Dr, Suite 2024, Fort Walton Beach, FL 32547-6960 | 2008-10-28 |
| 1184872756 | James Matthew Reynolds | Obstetrics & Gynecology | 1005 Mar Walt Drive, Ob/gyn Department, Fort Walton Beach, FL 32547-6796 | 2008-09-08 |
| 1578774642 | Carolyn Mcgrail | Obstetrics & Gynecology | 1703 Lewis Turner Blvd, Fort Walton Beach, FL 32547-1221 | 2007-05-24 |
| Find all providers in FORT WALTON BEACH | ||||
| City | FORT WALTON BEACH |
| Zip Code | 32547 |
Please comment or provide details below to improve the information on NORTHWEST FLORIDA WOMENS CANCER CARE LLC.
| 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.