Individual provider Active NPI

Jacqueline McGrath, PA

  • Physician Assistant
  • Crestview, FL
National Provider Identifier
1174316178
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
550 Redstone Ave W Ste 390
Crestview, FL 32536-6434
Phone
(850) 423-9976
NPI assigned
May 23, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2025

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 Primary

Addresses

Primary practice location

550 Redstone Ave W Ste 390
Crestview, FL 32536-6434

Mailing address

550 Redstone Ave W Ste 390
Crestview, FL 32536-6434

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
I20250806004582 FL Practitioner - Physician Assistant 0941708259 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Okaloosa Clinic CorpGroup PAC ID 0244205565, 27 clinicians

Practice addresses (Care Compare)

524 W James Lee Blvd
Crestview, FL 32536-5129
Phone (850) 398-8725

550 Redstone W Ave
Suite 370
Crestview, FL 32536-6429
Phone (850) 682-2209

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Okaloosa Clinic Corp CurrentSince Aug 1, 2025 Accepting new patients

Locations

550 Redstone Ave W
Ste 390
Crestview, FL 32536
Phone (850) 682-0077

1507 Merchants Way
Ste A
Niceville, FL 32578
Phone (850) 897-3600

Interoperability endpoints

  • Direct secure messaging: jacqueline.mcgrath.1@1523.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.

Hospital & facility affiliations 3

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": "1747958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747958400000",
    "number": "1174316178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 REDSTONE AVE W STE 390",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325366434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 REDSTONE AVE W STE 390",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325366434",
            "telephone_number": "850-423-9976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGRATH",
        "first_name": "JACQUELINE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-23",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestview, FL

Sources for this page

Verify at the official NPI Registry.