McMahon & Ricketson MD PA

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

MCMAHON & RICKETSON MD PA

Practice address

5147 N 9TH Ave
Ste. 203
Pensacola, FL 32504-8771

Phone

(850) 476-6110

Fax

(850) 479-6042

NPI assigned

Aug 8, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Kurt T. Stockamp, M.D.

Title

President

Phone

(850) 476-6110

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276646400000",
    "number": "1235149048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5147 N 9TH AVE",
            "address_2": "STE. 203",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048771",
            "telephone_number": "850-476-6110",
            "fax_number": "850-479-6042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5147 N 9TH AVE",
            "address_2": "STE. 203",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048771",
            "telephone_number": "850-476-6110",
            "fax_number": "850-479-6042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCMAHON & RICKETSON MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2010-06-16",
        "status": "A",
        "authorized_official_last_name": "STOCKAMP",
        "authorized_official_first_name": "KURT",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-476-6110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "45688",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AL MEDICAID",
            "identifier": "528302480",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "269452200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barbara Bonnie Butt McLean, OMD AP
• Julie McLean, OTR
• Bruce G McLennan, PAC
• Paul Allen McLeod, M.D.
• Ryan McLeod, RN
• Madison Jamie McManus, LMHC
• Scott D McMartin, MD
• Hayley Morgan McMichael, APRN
• John M McMillin, CRNA
• Benjamin McMillon, DC

• Surgery Physician in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2010; 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.