Individual provider Active NPI

Donald Sexton, PA-C

  • Physician Assistant
  • Crestview, FL
National Provider Identifier
1063480143
Registry record updated Mar 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9101215 Issued in FL
Practice address
550 Redstone Ave W
Suite 200
Crestview, FL 32536-6430
Phone
(850) 682-6122
Fax
(850) 682-5917
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9101215 FL Primary

Addresses

Primary practice location

550 Redstone Ave W
Suite 200
Crestview, FL 32536-6430

Mailing address

PO Box 2699
Pensacola, FL 32513-2699
Phone (850) 475-4500

Other identifiers 1

IdentifierTypeStateIssuer
291521900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9101215FLMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: donald.sexton.1@9582.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268784000000",
    "number": "1063480143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2699",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325132699",
            "telephone_number": "850-475-4500",
            "fax_number": "850-475-4619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 REDSTONE AVE W",
            "address_2": "SUITE 200",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325366430",
            "telephone_number": "850-682-6122",
            "fax_number": "850-682-5917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEXTON",
        "first_name": "DONALD",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2010-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9101215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "291521900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestview, FL

Sources for this page

Verify at the official NPI Registry.