Northwest Florida Diabetes & Nutrition Center, LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

NORTHWEST FLORIDA DIABETES & NUTRITION CENTER, LLC

Practice address

120 W Woodruff Ave
Crestview, FL 32536-3527

Phone

(850) 482-1830

NPI assigned

Oct 21, 2011

Organization subpart

No

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

Authorized official

Name

Patricia Ann Fletcher, PA-CNPI 1245299767

Title

MGRM

Phone

(850) 482-1830

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Patricia Ann Fletcher, PA

  • Physician Assistant
  • Crestview, FL
  • NPI 1245299767
  NPD (past) Authorized official
• Esther Christine Allen, PHYSICIAN ASSISTANT

  • Medical Physician Assistant
  • Eglin Afb, FL
  • NPI 1821139957
  NPD (past)

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

{
    "created_epoch": "1319155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389398400000",
    "number": "1043596091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1854",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325367854",
            "telephone_number": "850-482-1830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W WOODRUFF AVE",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325363527",
            "telephone_number": "850-482-1830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST FLORIDA DIABETES & NUTRITION CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-21",
        "last_updated": "2014-01-11",
        "status": "A",
        "authorized_official_last_name": "FLETCHER",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "MGRM",
        "authorized_official_telephone_number": "850-482-1830",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• North Okaloosa Clinic Corp
• North Okaloosa Clinic Corp
• North Okaloosa Health Care Associates LLC
• North Okaloosa Home Health, LLC
• Northland Hearing Center, Inc.
• Angel A Nunez, MD
• Nursetel
• Devin O'Hara, D.O.
• Dana Odom
• Okaloosa Cardiology P a

• Health Service Clinic/Center in Crestview, FL
• Providers in Crestview, FL by specialty
• Health Service Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2014; 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.