Kelly J Smidebush (NPI# 1104176833, PAC ID# 8527218056) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1104176833 |
| PAC ID by PECOS | 8527218056 |
| Professional Enrollment ID | I20121018000582 |
| Full Name | Kelly J Smidebush |
| Organization Legal Name | OKALOOSA CARDIOLOGY P A |
| Address |
921 Northwest Mar Walt Dr Fort Walton Beach FL 32547-6759 |
| Phone Number | 8506827212 |
| Gender | F |
| Graduation Year | 2012 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 7315920899 |
| Number of Group Practice Members | 11 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 100122 | NORTH OKALOOSA MEDICAL CENTER |
| 100223 | FORT WALTON BEACH MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 921 Northwest Mar Walt Dr, Fort Walton Beach, FL 32547-6759 | 8506827212 | OKALOOSA CARDIOLOGY P A |
| 1905 Andorra St, Suite 100, Navarre, FL 32566-9111 | 8506827212 | OKALOOSA CARDIOLOGY P A |
| Organization Legal Name | OKALOOSA CARDIOLOGY P A |
| Physicians | 9 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ian L Weisberg | Cardiac Electrophysiology | Okaloosa Cardiology P A | 129 E Redstone Ave, Suite A, Crestview, FL 32539-5350 |
| Marcello A Borzatta | Vascular Surgery | Okaloosa Cardiology P A | 129 E Redstone Ave, Suite A, Crestview, FL 32539-5350 |
| Ajit Janardhan | Cardiac Electrophysiology | Okaloosa Cardiology P A | 129 E Redstone Ave, Suite A, Crestview, FL 32539-5350 |
| Anthony Sayah Al Dehneh | Cardiovascular Disease (cardiology) | Okaloosa Cardiology P A | 129 E Redstone Ave, Suite A, Crestview, FL 32539-5350 |
| Angel Morrobel | Cardiovascular Disease (cardiology) | Okaloosa Cardiology P A | 129 E Redstone Ave, Suite A, Crestview, FL 32539-5350 |
| Kaitlin L Bennett | Physician Assistant | Okaloosa Cardiology P A | 129 E Redstone Ave, Suite A, Crestview, FL 32539-5350 |
| Brittany Nicole Grimes | Nurse Practitioner | Okaloosa Cardiology P A | 129 E Redstone Ave, Suite A, Crestview, FL 32539-5350 |
| Mark Katzenstein | Cardiovascular Disease (cardiology) | Okaloosa Cardiology P A | 921 Northwest Mar Walt Dr, Fort Walton Beach, FL 32547-6759 |
| Street Address |
921 NORTHWEST MAR WALT DR |
| City | FORT WALTON BEACH |
| State | FL |
| Zip | 32547-6759 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mark Katzenstein | Cardiovascular Disease (cardiology) | Okaloosa Cardiology P A | 921 Northwest Mar Walt Dr, Fort Walton Beach, FL 32547-6759 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Morris E Gales Iii | General Surgery | Florida Post Acute Care Clinicians LLC | 1 L B J Sr Dr, Fort Walton Beach, FL 32547-1163 |
| John D Sites | Family Medicine | Magnolia Medical Clinic P.a. | 319 Green Acres Rd, Suite 101, Fort Walton Beach, FL 32547-1170 |
| Teresa Marie Skojac | Family Medicine | Magnolia Medical Clinic P.a. | 319 Green Acres Rd, Suite 101, Fort Walton Beach, FL 32547-1170 |
| Peter Kerr Senechal | Family Medicine | Magnolia Medical Clinic P.a. | 319 Green Acres Rd, Suite 101, Fort Walton Beach, FL 32547-1170 |
| Chris George Pappas | Family Medicine | Magnolia Medical Clinic P.a. | 319 Green Acres Rd, Suite 101, Fort Walton Beach, FL 32547-1170 |
| Christopher P Paulson | Family Medicine | Magnolia Medical Clinic P.a. | 319 Green Acres Rd, Suite 101, Fort Walton Beach, FL 32547-1170 |
| Susan T Ott | Nurse Practitioner | Magnolia Medical Clinic P.a. | 319 Green Acres Rd, Suite 101, Fort Walton Beach, FL 32547-1170 |
| Brandy Marie Lackey | Nurse Practitioner | Magnolia Medical Clinic P.a. | 319 Green Acres Rd, Suite 101, Fort Walton Beach, FL 32547-1170 |
| Grant Eugene Zachary | Family Medicine | Magnolia Medical Clinic P.a. | 319 Green Acres Rd, Suite 101, Fort Walton Beach, FL 32547-1170 |
| Jamison E Gaddy | Physician Assistant | Australian Lungfish Surgical Specialists LLC | 1703 Lewis Turner Blvd, Fort Walton Beach, FL 32547-1221 |
| Find all physicians in zip 32547 | |||
| City | FORT WALTON BEACH |
| Zip Code | 32547 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | FORT WALTON BEACH + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Kelly J Smidebush.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.