Pensacola Pediatrics PA

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

PENSACOLA PEDIATRICS PA

Practice address

1368 Country Club Rd
Gulf Breeze, FL 32563-3471

Phone

(850) 934-9876

Fax

(850) 916-0736

NPI assigned

Jul 29, 2021

Last updated

Jul 29, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Peter Heckathorn

Title

Administrator

Phone

(850) 473-0100

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Pensacola Pediatrics PA9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

• Pensacola Pediatrics PA

  • Pediatrics Physician
  • Pensacola, FL
  • NPI 1144302324
  NPD tax ID
• Pensacola Pediatrics PA

  • Pediatrics Physician
  • Pace, FL
  • NPI 1225701550
  NPD tax ID
• Pensacola Pediatrics PA

  • Pediatrics Physician
  • Milton, FL
  • NPI 1356200315
  NPD tax ID
• Pensacola Pediatrics PA

  • Pediatrics Physician
  • Navarre, FL
  • NPI 1467178343
  NPD tax ID
• Pensacola Pediatrics PA

  • Pediatrics Physician
  • Milton, FL
  • NPI 1508539834
  NPD tax ID
• Pensacola Pediatrics, PA

  • Pediatrics Physician
  • Pensacola, FL
  • NPI 1255004586
  NPD tax ID
• Pensacola Pediatrics, PA

  • Pediatrics Physician
  • Pensacola, FL
  • NPI 1790451508
  NPD tax ID
• Pensacola Pediatrics, PA

  • Pediatrics Physician
  • Pensacola, FL
  • NPI 1801649686
  NPD tax ID

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

{
    "created_epoch": "1627516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627516800000",
    "number": "1013680651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4951 GRANDE DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048965",
            "telephone_number": "850-473-0100",
            "fax_number": "850-473-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1368 COUNTRY CLUB RD",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325633471",
            "telephone_number": "850-934-9876",
            "fax_number": "850-916-0736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENSACOLA PEDIATRICS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-29",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A",
        "authorized_official_last_name": "HECKATHORN",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "850-473-0100"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "063018701",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Lance Pennington, CRNA
• Pensacola Emergency Physicians, LLC
• Pensacola Hospitalist Physicians, LLC
• Pensacola Nephrology, PA (Renalus Center for Kidney Care)
• Pensacola Nephrology, PA (Renalus Center for Kidney Care)
• Perdido Rentals, LLC (Quality Medical Consulting)
• Brian F Perez, MD
• Stephanie Slorahn Peterson, LCSW
• Abigail Petska, RBT
• Janice Pettigrew, ARNP

• Pediatrics Physician in Gulf Breeze, FL
• Providers in Gulf Breeze, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.

Verify at the official NPI Registry.