PENSACOLA NEPHROLOGY PA (NPI# 1871535955) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871535955 |
| Entity Type | Organization |
| Organization Name | PENSACOLA NEPHROLOGY PA |
| Other Organization Name | THE KIDNEY GROUP |
| Practice Address |
925 Mar Walt Dr Suite 1 Ft Walton Beach FL 32547-6759 |
| Mailing Address |
1717 N E St Suite 403 Pensacola FL 32501-6339 |
| Practice Telephone | 8508622385 |
| Practice Fax Number | 8508620482 |
| Mailing Telephone | 8504444700 |
| Mailing Fax Number | 8504449766 |
| Enumeration Date | 2006-06-12 |
| 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 | 256870504 | 05 | |
| FL | 256870505 | 05 | |
| FL | 256870506 | 05 | |
| FL | BCBS OF FLORIDA | 99659 | 01 |
| RR MEDICARE | CF9776 | 01 | |
| FL | 256870500 | 05 | |
| FL | MED3000/HEALTH 1ST NETWOR | 0358 | 01 |
| FL | 256870507 | 05 | |
| FL | 256870508 | 05 | |
| FL | 256870502 | 05 | |
| AL | 529904030 | 05 | |
| FL | 256870503 | 05 |
| Other Name | Type Code |
|---|---|
| The Kidney Group | Doing Business As Name - Organization |
| 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 |
| 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 |
| 1033167374 | Pensacola Nephrology Pa | Specialist | 550 Redstone Ave W, Suite 200, Crestview, FL 32536-6428 | 2006-05-05 |
| 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 |
925 MAR WALT DR SUITE 1 |
| City | FT WALTON BEACH |
| State | FL |
| Zip Code | 32547-6759 |
| 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 | 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. |
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| 1437758893 | Ursula Olazabal | Specialist | 402 N Babcock St Ste 101, Melbourne, FL 32935-7335 | 2020-10-18 |
| 1043818529 | Michele Rosenthal | Specialist | 425 Greenwich Circle, #107, Jupiter, FL 33458-4809 | 2020-10-15 |
| 1184230096 | Lauren Daisey Woodruff | Specialist | 4440 Nelson Ave, Sarasota, FL 34231-7515 | 2020-09-17 |
| 1699385823 | Suzanne Denise Moe | Specialist | 48 Nw 4th St, Homestead, FL 33030-5942 | 2020-08-03 |
| 1437768033 | Coastal Injury Clinic LLC | Specialist | 2700 Riverside Ave Ste 1, Jacksonville, FL 32205-8233 | 2020-07-29 |
| 1417566712 | Angela Berry Williams | Specialist | 5175 W Atlantic Ave Ste C, Delray Beach, FL 33484-8101 | 2020-07-23 |
| 1255957643 | Rhonda D Smith Roberts | Specialist | 2754 Sam Hardwick Blvd, Jacksonville, FL 32246-3892 | 2020-06-22 |
| 1316562911 | A School 4 Legends LLC | Specialist | 11565 Se 57th Ct, Belleview, FL 34420-4361 | 2020-06-10 |
| 1700400397 | Juda Mclaren | Specialist | 7360 Beacon Hill Loop Apt 8, Orlando, FL 32818-6431 | 2020-05-30 |
| 1811518384 | Lori Rubin | Specialist | 8181 W Broward Blvd Ste 204, Plantation, FL 33324-2049 | 2020-05-06 |
| Find all providers with the same taxonomy | ||||
| City | FT 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.