Active NPI
Andrea M Person, PA
- Physician Assistant
- Fort Walton Beach, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- C07180
- Practice address
- 1000 Mar Walt Dr
Fort Walton Beach, FL 32547-6708 - Phone
- (850) 862-1111
- NPI assigned
- Jul 5, 2006
- Last updated
- Aug 6, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | PA9105278 | FL | |
| Medical Physician Assistant | 363AM0700X | PA458 | GA | |
| Physician Assistant | 363A00000X | C07180 | MD | Primary |
Addresses
Primary practice location
1000 Mar Walt Dr
Fort Walton Beach, FL 32547-6708
Mailing address
19801 Observation Dr
Germantown, MD 20876-4070
Phone (301) 557-6000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 292457900 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC, MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
12321 Middlebrook Rd
Suite 101
Germantown, MD 20874-1512
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004810 | GA | MD | Professional Counselor |
| PA9105278 | FL | MD | Emergency Medicine Physician |
| C07180 | MD | MD | Physician Assistant |
| PA458 | GA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medstar Urgent Care LLC | Current | Accepting new patients | |
| Medstar Urgent Care, LLC | Current | Accepting new patients | |
| Emergency Providers Group LLC | Emergency Medicine | Past | Accepting new patients |
Locations
6317 York Rd
Baltimore, MD 21212
Phone (443) 777-6890
19777 Frederick Rd
Germantown, MD 20876
Phone (240) 388-9314
7698 Dorchester Blvd
Ste 204
Hanover, MD 21076
12220 Rockville Pike
Rockville, MD 20852
Phone (301) 468-6483
3064 Waldorf Market Pl
Waldorf, MD 20603
Phone (301) 932-5960
3350 Crain Hwy
Waldorf, MD 20603
Phone (443) 332-4260
11915 Georgia Ave
Wheaton, MD 20902
Phone (301) 942-4505
Interoperability endpoints
- andrea.person.1@20907.direct.athenahealth.com
- https://api.platform.athenahealth.com/20907/brand/2/csg/1/fhir/r4
Organizations & group practices 8
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.
-
dba Tru Primary Care
- Primary Care Clinic/Center
- Germantown, MD
- NPI 1457322505
DC
-
dba Tru Urgent Care DMV
- Urgent Care Clinic/Center
- Germantown, MD
- NPI 1144291204
DC
-
dba MedStar PromptCare-Wheaton
- Urgent Care Clinic/Center
- Wheaton, MD
- NPI 1871843409
DC
-
dba Righttime Medical Care
- Emergency Medicine Physician
- Rockville, MD
- NPI 1912911215
-
dba MedStar PromptCare
- Urgent Care Clinic/Center
- Baltimore, MD
- NPI 1902175870
-
- General Practice Physician
- Lexington Park, MD
- NPI 1275410474
-
- Emergency Medicine Physician
- Fort Walton Beach, FL
- NPI 1164711206
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565049600000",
"number": "1003847302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19801 OBSERVATION DR",
"city": "GERMANTOWN",
"state": "MD",
"postal_code": "208764070",
"telephone_number": "301-557-6000",
"fax_number": "954-377-3042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 MAR WALT DR",
"city": "FORT WALTON BEACH",
"state": "FL",
"postal_code": "325476708",
"telephone_number": "850-862-1111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERSON",
"first_name": "ANDREA",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-05",
"last_updated": "2019-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "FL",
"license": "PA9105278",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "GA",
"license": "PA458",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MD",
"license": "C07180",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "292457900",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Walton Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.