NPIMap

Organization Active NPI

North Florida Medical Centers Inc

Doing business as Crestview Health Center

  • Federally Qualified Health Center (FQHC)
  • Crestview, FL
National Provider Identifier
1194908954
Registry record updated Jun 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
NORTH FLORIDA MEDICAL CENTERS INC
Doing business as
Crestview Health Center
Practice address
800 Hospital Dr
Crestview, FL 32539-7385
Phone
(850) 682-1164
Fax
(850) 682-5302
NPI assigned
Dec 14, 2007
Last updated
Jun 26, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTH FLORIDA MEDICAL CENTERS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 26, 2026

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

Authorized official

Name
Lane Miller Lunn
Title
President/Ceo
Phone
(850) 385-4494

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X FL Primary

Addresses

Primary practice location

800 Hospital Dr
Crestview, FL 32539-7385

Mailing address

2804 Remington Green Cir Ste 2
Tallahassee, FL 32308-1550
Phone (850) 385-4494

Other identifiers 2

IdentifierTypeStateIssuer
99388OtherFLMEDICARE PART B, GROUP PTAN
CE1606OtherFLRAILROAD MEDICARE

Other names 1

  • Crestview Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040102000848 FL Part B Supplier - Clinic/Group Practice 6103737697 Receives reassigned benefits from 21 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Quincy, FL; Wewahitchka, FL; Tallahassee, FL; Perry, FL; Panacea, FL; Madison, FL; Crestview, FL; Eastpoint, FL…
O20080328000730 FL Part A Provider - Federally Qualified Health Center (FQHC) 6103737697 Practice locations: Crestview, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194908954. Details of each certification follow.

Federally qualified health center certification: CCN 101814

Legal name
NORTH FLORIDA MEDICAL CENTERS INC
Doing business as
NORTH FLORIDA MEDICAL - CRESTVIEW
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 13, 2008
Last certification
May 13, 2008
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Nov 5, 1996 in FL
Enrollment address
800 Hospital Dr
Crestview, FL 32539-7385

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Wakulla Medical Center16 organizations share this tax ID, including this one
Part of
Wakulla Medical Center

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

Locations

469 W Base St
Madison, FL 32340
Phone (850) 253-3454

1850 S Byron Butler Pkwy
Perry, FL 32348
Phone (850) 838-2030

1249 Strong Rd
Quincy, FL 32351
Phone (850) 875-9500

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Patrick Williams Individual Corporate DirectorMember May 28, 2015
Barbara E Coulthurst Individual Corporate Director Jan 1, 2007
Benjamin Harriss Individual Corporate OfficerBoard Member Jun 1, 2018
Champee Kemp Individual Corporate OfficerBoard Member Apr 22, 2021
Stan Johnson Individual Corporate OfficerVice-Chair Apr 22, 2021
Victoria R Wiggins Individual Corporate OfficerVP/Cfo Oct 1, 2016
W-2 Managing Employee Oct 1, 2016
Lane Lunn Individual Corporate OfficerPresident/Ceo Apr 1, 2017
W-2 Managing EmployeePresident/Ceo Apr 1, 2017
Ella Mae Parrish Individual Corporate OfficerChair Apr 22, 2021
Ferrell Delores Mayhann Individual Corporate Director Jan 1, 2007
Robert Grayson Shepard Individual Corporate OfficerChair May 28, 2015
Berta Jean Kemp Individual Corporate Director Jan 1, 2007
Perla Palomo Individual Corporate OfficerBoard Member Sep 1, 2019

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
North Monroe Medical CenterTallahassee, FL, CCN 681123 Federally qualified health center Operational/Managerial Control Jan 25, 2018

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1197590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782432000000",
    "number": "1194908954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2804 REMINGTON GREEN CIR STE 2",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323081550",
            "telephone_number": "850-385-4494",
            "fax_number": "850-298-6054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 HOSPITAL DR",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325397385",
            "telephone_number": "850-682-1164",
            "fax_number": "850-682-5302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH FLORIDA MEDICAL CENTERS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH FLORIDA MEDICAL CENTERS, INC.",
        "enumeration_date": "2007-12-14",
        "last_updated": "2026-06-26",
        "certification_date": "2026-06-26",
        "status": "A",
        "authorized_official_last_name": "LUNN",
        "authorized_official_first_name": "LANE",
        "authorized_official_middle_name": "MILLER",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "850-385-4494"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B, GROUP PTAN",
            "identifier": "99388",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CE1606",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crestview Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Crestview, FL

Sources for this page

Verify at the official NPI Registry.