CHP Gulf Breeze FL Tenant Corp

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

CHP GULF BREEZE FL TENANT CORP

Doing business as

The Beacon at Gulf Breeze

Practice address

4410 Gulf Breeze Pkwy
Gulf Breeze, FL 32563-8130

Phone

(850) 378-3432

NPI assigned

Mar 5, 2019

Organization subpart

No

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

Authorized official

Name

Seth Walker

Title

Cfo

Phone

(850) 583-7990

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Beacon at Gulf Breeze Doing business as

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

{
    "created_epoch": "1551744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711324800000",
    "number": "1174081525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2528 BARRINGTON CIR STE 2",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323083888",
            "telephone_number": "850-583-7990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4410 GULF BREEZE PKWY",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325638130",
            "telephone_number": "850-378-3432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHP GULF BREEZE FL TENANT CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-05",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "SETH",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "850-583-7990"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102061400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Beacon at Gulf Breeze",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Madeline Chambers, APRN
• Shannon Chambers
• David Ray Chandler, MD
• Child Neurology Center of Northwest Florida PA
• Child Neurology Center of NW FL PA
• Karlee Clark, APRN
• Meredith Clark, ATC
• Ronald Harris Clayton
• Renea Kathleen Clowdsley, APRN
• Club2,LLC

• Assisted Living Facility in Gulf Breeze, FL
• Providers in Gulf Breeze, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; 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.