HQM of Port St. Joe, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

SNF1038096 Issued in TN

Legal business name

HQM OF PORT ST. JOE, LLC

Practice address

220 9TH St
Port St. Joe, FL 32456

Phone

(850) 229-8244

NPI assigned

Jan 17, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Paul Walczak

Title

Ceo

Phone

(561) 627-0664

Specialties & licenses 1

Addresses

Other names 1

• Bay St. Joseph Care & Rehabilitation Center Doing business as

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043299142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 9TH ST",
            "city": "PORT ST. JOE",
            "state": "FL",
            "postal_code": "32456",
            "telephone_number": "850-229-8244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 9TH ST",
            "city": "PORT ST. JOE",
            "state": "FL",
            "postal_code": "32456",
            "telephone_number": "850-229-8244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HQM OF PORT ST. JOE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALCZAK",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "561-627-0664",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TN",
            "license": "SNF1038096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bay St. Joseph Care & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stacy L Harbin, MD
• Noel Jason Hartough, LMHC
• Eric Haynam, D.D.S
• Amy Wynn Heath, RN
• Kelley Nicole Hensley, DC
• Paul J Hunt Jr., M.D.
• Tracey Hyche, PHARMD, CPH
• Integras Therapy and Wellness Centers Inc.
• Vincent M Ivers
• Sharon Denise Jackson, RN

• Skilled Nursing Facility in Port St. Joe, FL
• Providers in Port St. Joe, FL by specialty
• Skilled Nursing Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.