Individual provider Active NPI

Thanh Huynh, APRN

  • Acute Care Nurse Practitioner
  • Fort Walton Beach, FL
National Provider Identifier
1104678283
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APRN11032130 Issued in FL
Practice address
1032 Mar Walt Dr Unit 230
Fort Walton Beach, FL 32547-6661
Phone
(850) 862-3194
Fax
(850) 862-4423
NPI assigned
Apr 3, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APRN11032130 FL Primary

Addresses

Primary practice location

1032 Mar Walt Dr Unit 230
Fort Walton Beach, FL 32547-6661

Mailing address

1032 Mar Walt Dr Unit 230
Fort Walton Beach, FL 32547-6661
Phone (850) 862-3194

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240426000522 FL Practitioner - Nurse Practitioner 3476993247 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Florida Multispecialty Physicians LLCGroup PAC ID 5597801779, 16 clinicians

Practice addresses (Care Compare)

1032 Mar Walt Dr
Suite 230
Ft. Walton Beach, FL 32547-6663
Phone (850) 862-3194

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Florida Multispecialty Physicians LLC CurrentSince May 6, 2024 Accepting new patients

Locations

1032 Mar Walt Dr
Unit 230
Ft Walton Bch, FL 32547
Phone (850) 862-3194

2202 State Ave
Ste 111
Panama City, FL 32405
Phone (850) 763-5409

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • Direct secure messaging: thanh.huynh@hca5.eclinicaldirectplus.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1712102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1104678283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1032 MAR WALT DR UNIT 230",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476661",
            "telephone_number": "850-862-3194",
            "fax_number": "850-862-4423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1032 MAR WALT DR UNIT 230",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476661",
            "telephone_number": "850-862-3194",
            "fax_number": "850-862-4423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUYNH",
        "first_name": "THANH",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-03",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "APRN11032130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

Verify at the official NPI Registry.