Individual provider Active NPI

Ralyn Dee Noland, FNP-C

  • Primary Care Nurse Practitioner
  • Pensacola, FL
National Provider Identifier
1174346357
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
APRN11036348 Issued in FL
Practice address
5111 N 12TH Ave
Pensacola, FL 32504-8918
Phone
(850) 226-6801
Fax
(877) 413-5104
NPI assigned
Nov 5, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X APRN11036348 FL Primary

Addresses

Primary practice location

5111 N 12TH Ave
Pensacola, FL 32504-8918

Mailing address

7209 Clydesdale Dr
Pensacola, FL 32506-5181
Phone (662) 386-3339

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
I20250423003810 FL Practitioner - Nurse Practitioner 6305362229 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dynamic Pain and Wellness LLCGroup PAC ID 8527364058, 29 clinicians

Practice addresses (Care Compare)

5111 N 12TH Ave
Pensacola, FL 32504-8918
Phone (850) 226-6801

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11036348FLMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dynamic Pain & Wellness LLC CurrentSince Feb 17, 2025 Accepting new patients
Dynamic Pain & Wellness LLC CurrentSince Feb 17, 2025 Accepting new patients

Locations

210 S Main St
Crestview, FL 32536
Phone (850) 306-3433

930 Mar Walt Dr
Unit C
Fort Walton Beach, FL 32547
Phone (850) 431-6183

930 Mar Walt Dr
Fort Walton Beach, FL 32547
Phone (850) 331-2930

5111 N 12th Ave
Pensacola, FL 32504
Phone (850) 291-7641

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": "1730764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1174346357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7209 CLYDESDALE DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325065181",
            "telephone_number": "662-386-3339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5111 N 12TH AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048918",
            "telephone_number": "850-226-6801",
            "fax_number": "877-413-5104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLAND",
        "first_name": "RALYN",
        "middle_name": "DEE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-05",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "APRN11036348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.