Primary Care South, Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

PRIMARY CARE SOUTH, INC

Practice address

5551 US Highway 98
Santa Rosa Beach, FL 32459

Phone

(850) 420-5420

Fax

(850) 244-8011

NPI assigned

Oct 4, 2019

Last updated

Oct 10, 2022By 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

Kimmie Hunter

Title

Credential

Phone

(850) 420-5420

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rachael Arnett, APRN, FNP-C

  • Nurse Practitioner
  • Santa Rosa Beach, FL
  • NPI 1326639162
  Medicare reassignment Care Compare group NPD
• Lindsay Entrekin, FNP-C

  • Family Nurse Practitioner
  • Santa Rosa Beach, FL
  • NPI 1871370015
  Medicare reassignment Care Compare group NPD
• Matthew Patton, APRN

  • Family Nurse Practitioner
  • Santa Rosa Beach, FL
  • NPI 1548872567

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Michael T Patton, D.O.

  • Internal Medicine Physician
  • Santa Rosa Beach, FL
  • NPI 1245200633

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Richard Magana, PA-C

  • Physician Assistant
  • Santa Rosa Beach, FL
  • NPI 1720686116
  Medicare reassignment Care Compare group
• Alexandrea Warren, FNP-C, CDE, BC-ADM

  • Family Nurse Practitioner
  • Destin, FL
  • NPI 1619300753
  Medicare reassignment NPD

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

{
    "created_epoch": "1570147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665360000000",
    "number": "1093356685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5551 US HIGHWAY 98",
            "city": "SANTA ROSA BEACH",
            "state": "FL",
            "postal_code": "32459",
            "telephone_number": "850-420-5420",
            "fax_number": "850-244-8011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5551 US HIGHWAY 98",
            "city": "SANTA ROSA BEACH",
            "state": "FL",
            "postal_code": "32459",
            "telephone_number": "850-420-5420",
            "fax_number": "850-244-8011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE SOUTH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-04",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A",
        "authorized_official_last_name": "HUNTER",
        "authorized_official_first_name": "KIMMIE",
        "authorized_official_title_or_position": "CREDENTIAL",
        "authorized_official_telephone_number": "850-420-5420"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104684300",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "http://www.primarycaresouth.com/",
            "affiliation": "N",
            "address_1": "5551 US HIGHWAY 98",
            "city": "SANTA ROSA BEACH",
            "state": "FL",
            "country_code": "US",
            "postal_code": "32459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Claire Ragsdale
• Robert Clifford Ratcliff, DDS
• John Roger Rebillot, M. A.

• Internal Medicine Physician in Santa Rosa Beach, FL
• Providers in Santa Rosa Beach, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.