Individual provider Active NPI

Karl Walter Metz, M.D.

  • Gynecology Physician
  • Fort Walton Beach, FL
National Provider Identifier
1134104169
Registry record updated Jan 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
ME44775 Issued in FL
Practice address
1005 Mar Walt Dr
Laboratory
Fort Walton Beach, FL 32547-6707
Phone
(850) 863-8109
Fax
(850) 862-5989
NPI assigned
Dec 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X ME44775 FL Primary

Addresses

Primary practice location

1005 Mar Walt Dr
Laboratory
Fort Walton Beach, FL 32547-6707

Mailing address

1005 Mar Walt Dr
Laboratory
Fort Walton Beach, FL 32547-6707
Phone (850) 863-8109

Other identifiers 2

IdentifierTypeStateIssuer
043130300MedicaidFL
46197OtherFLBCBSFL

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091230000221 FL Practitioner - General PracticePractitioner - Obstetrics/Gynecology 1759461866 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Tulane University School of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
White-Wilson Medical Center PAGroup PAC ID 4082510607, 48 clinicians

Practice addresses (Care Compare)

1005 Mar Walt Dr
Fort Walton Beach, FL 32547-6707
Phone (850) 863-8150

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME44775FLMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
White-Wilson Medical Center PA CurrentSince Aug 6, 1984 Accepting new patients

Locations

1005 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 863-8100

Interoperability endpoints

  • Direct secure messaging: karl.metz.1@21123.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484524800000",
    "number": "1134104169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 MAR WALT DR",
            "address_2": "LABORATORY",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476707",
            "telephone_number": "850-863-8109",
            "fax_number": "850-862-5989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 MAR WALT DR",
            "address_2": "LABORATORY",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476707",
            "telephone_number": "850-863-8109",
            "fax_number": "850-862-5989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METZ",
        "first_name": "KARL",
        "middle_name": "WALTER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-13",
        "last_updated": "2017-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "FL",
            "license": "ME44775",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "043130300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSFL",
            "identifier": "46197",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

Verify at the official NPI Registry.