Individual provider Active NPI

Adam C Hargis, NP

  • Nurse Practitioner
  • Crestview, FL
National Provider Identifier
1003372194
Registry record updated Feb 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11001492 Issued in FL
Practice address
151 E Redstone Ave
Crestview, FL 32539-5352
Phone
(859) 669-8100
NPI assigned
Feb 14, 2019
Last updated
Feb 27, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11001492 FL Primary

Addresses

Primary practice location

151 E Redstone Ave
Crestview, FL 32539-5352

Mailing address

5845 Bethelridge Cir
Crestview, FL 32536-9356
Phone (850) 826-2971

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190227002312 FL Practitioner - Nurse Practitioner 8820337314 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Steven S Donchey MdpaGroup PAC ID 5890860373, 14 clinicians

Practice addresses (Care Compare)

151 E Redstone Ave
Crestview, FL 32539-5352
Phone (850) 689-8100

1950 Bluewater Blvd
Suite 201
Niceville, FL 32578-3888
Phone (850) 685-3604

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11001492FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Floridian Emergency Specialists LLC Current Accepting new patients
Floridian Hospitalist Services, LLC Current Accepting new patients
Steven S Donchey Mdpa CurrentSince Sep 4, 2019 Accepting new patients

Locations

1950 Bluewater Blvd
Ste 201
Niceville, FL 32578
Phone (850) 685-3604

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1550102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551225600000",
    "number": "1003372194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5845 BETHELRIDGE CIR",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325369356",
            "telephone_number": "850-826-2971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 E REDSTONE AVE",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325395352",
            "telephone_number": "859-669-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARGIS",
        "first_name": "ADAM",
        "middle_name": "C",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-14",
        "last_updated": "2019-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11001492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestview, FL

Sources for this page

Verify at the official NPI Registry.