Commons Drive Family Medicine

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME119611 Issued in FL

Legal business name

COMMONS DRIVE FAMILY MEDICINE

Practice address

4012 Commons Dr W Ste 112
Destin, FL 32541-8424

Phone

(304) 552-7412

NPI assigned

Aug 6, 2015

Last updated

Aug 6, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mohamad S Kalou, MDNPI 1619065190

Title

Owner

Phone

(304) 552-7412

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Mohamad Samah Kalou, MD

  • Addiction Medicine (Family Medicine) Physician
  • Charleston, WV
  • NPI 1619065190

  Multi-Specialty

  NPD Authorized official

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

{
    "created_epoch": "1438819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438819200000",
    "number": "1235515727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4012 COMMONS DR W STE 112",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325418424",
            "telephone_number": "304-552-7412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4012 COMMONS DR W STE 112",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325418424",
            "telephone_number": "304-552-7412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONS DRIVE FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-06",
        "last_updated": "2015-08-06",
        "status": "A",
        "authorized_official_last_name": "KALOU",
        "authorized_official_first_name": "MOHAMAD",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-552-7412",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME119611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Coastal Urology P a
• Coastal Vascular and Interventional PLLC
• Coastal Vascular and Interventional PLLC
• Johannes Hendrik Coetzee, MD, MPH
• Comfortable Care Dental Health Professionals, P.a. (The Center for Cosmetic and Family Dentistry - Destin)
• Commons Drive Family Medicine, LLC
• Compass Physical Therapy
• Christine Clare Condit
• Richard E Corley, D.D.S
• Shayann Crabtree

• Family Medicine Physician in Destin, FL
• Providers in Destin, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2015; 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.