NPIMap

Organization Active NPI

West Florida Medical Center Clinic PA

  • Ambulatory Surgical Clinic/Center
  • Pensacola, FL
National Provider Identifier
1043396245
Registry record updated Feb 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
791 Issued in FL
Legal business name
WEST FLORIDA MEDICAL CENTER CLINIC PA
Practice address
8333 N Davis Hwy
Pensacola, FL 32514-6050
Phone
(850) 969-2121
Fax
(850) 969-2989
NPI assigned
Oct 31, 2006
Organization subpart
Yes
Parent organization
WEST FLORIDA MEDICAL CENTER CLINIC PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 13, 2012

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

Authorized official

Name
Marshall Andy Popple
Title
President
Phone
(850) 474-8724

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 791 FL Primary

Addresses

Primary practice location

8333 N Davis Hwy
Pensacola, FL 32514-6050

Mailing address

8333 N Davis Hwy
Pensacola, FL 32514-6050
Phone (850) 969-2121

Other identifiers 4

IdentifierTypeStateIssuer
68-01811OtherUNITED HEALTH CARE
490002804OtherGAPALMETO MEDICARE
079184900MedicaidFL
64COtherBLUE CROSS OF FLORIDA

Other names 1

  • Medical Center Clinic Ambulatory Surgical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060309000238 FL Part B Supplier - Ambulatory Surgical Center 7416860705 Practice locations: Pensacola, FL

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
West Florida Medical Center Clinic PACCN 10C0001234
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Part of
West Florida Med Ctr CLN

Practitioners & affiliated clinicians

Practitioners 440

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

View all 440

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329091200000",
    "number": "1043396245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8333 N DAVIS HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325146050",
            "telephone_number": "850-969-2121",
            "fax_number": "850-969-2989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8333 N DAVIS HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325146050",
            "telephone_number": "850-969-2121",
            "fax_number": "850-969-2989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST FLORIDA MEDICAL CENTER CLINIC PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WEST FLORIDA MEDICAL CENTER CLINIC PA",
        "enumeration_date": "2006-10-31",
        "last_updated": "2012-02-13",
        "status": "A",
        "authorized_official_last_name": "POPPLE",
        "authorized_official_first_name": "MARSHALL",
        "authorized_official_middle_name": "ANDY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-474-8724"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "FL",
            "license": "791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "68-01811",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETO MEDICARE",
            "identifier": "490002804",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "079184900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF FLORIDA",
            "identifier": "64C",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical Center Clinic Ambulatory Surgical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.