12TH Avenue Healthcare, Inc

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

12TH AVENUE HEALTHCARE, INC

Practice address

1101 Office Woods Dr
Pensacola, FL 32504-5937

Phone

(850) 776-7872

Fax

(850) 474-9060

NPI assigned

Dec 20, 2022

Organization subpart

No

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

Authorized official

Name

Emily Stinnett, APRN - FNPNPI 1093121790

Title

President

Phone

(850) 776-7872

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Emily Jane Stinnett

  • Family Nurse Practitioner
  • Gulf Breeze, FL
  • NPI 1093121790

  Family, FL

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1671494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671494400000",
    "number": "1003528258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9735 N PALAFOX ST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325341224",
            "telephone_number": "850-776-7872",
            "fax_number": "850-474-9060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 OFFICE WOODS DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325045937",
            "telephone_number": "850-776-7872",
            "fax_number": "850-474-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "12TH AVENUE HEALTHCARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-20",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A",
        "authorized_official_last_name": "STINNETT",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-776-7872",
        "authorized_official_credential": "APRN - FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Pensacola, FL
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.