Florida Department of Health
Organization Active NPI Public Health or Welfare Agency · Madison, FL
NPI 1245200641 · NPPES record last updated Aug 7, 2023
Key facts
- NPI
- 1245200641
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Public Health or Welfare Agency 251K00000X
- Legal business name
- FLORIDA DEPARTMENT OF HEALTH
- Practice address
- 218 SW Third Ave
Madison, FL 32340-1266 - Phone
- (850) 973-5000
- Fax
- (850) 973-5007
- NPI assigned
- Jan 26, 2006
- Organization subpart
- No
Authorized official
- Name
- Kim Barnhill
- Title
- Administrator Jefferson Madison CHD
- Phone
- (850) 973-5000
Practitioners 30
-
Brittany Hobbs Bishop, ARNP-C
-
Macy Ely, DNP, ARNP, FNP-C
-
Juanita Webb Fico, ARNP
-
Alicia Cosma Gilbert, FNP
-
Hantz C Hercule, M.D, PH.D
-
Kathleen McKeon, ARNP, CNM
-
Andrea Sciberras, D.O.
-
Averill Burger, FNP-BC
-
Lindsey Wells, MD
-
Miriam Ruth Gurniak, CNM ARNP
-
Jerry D Boland, M.D.
-
Kim Curry, PHD, ARNP
-
Elizabeth A Heuler, ARNP-C
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D1081603 | Madison County Health Department | Provider-performed microscopy | Mar 19, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| Walton Community Health Center |
Federally qualified health center | Operational/Managerial Control (100%) | Sep 7, 2010 |
| Bradford Community Health Care Inc |
Federally qualified health center | Operational/Managerial Control (100%) | Oct 1, 2013 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140616001088 | FL | Part B Supplier - Clinic/Group Practice | 3072424282 |
Receives reassigned benefits from 12 practitioners Practice locations: Madison, FL |
National Provider Directory
Locations
218 SW Third Ave
Madison, FL 32340
Phone (850) 972-5000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health or Welfare Agency | 251K00000X | FL | Yes |
Addresses
Primary practice location
218 SW Third Ave
Madison, FL 32340-1266
Mailing address
218 SW Third Ave
Madison, FL 32340-1266
Phone (850) 973-5000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 029040800 | Medicaid | FL |
Other names
- Madison County Health Department
Other providers in Madison, FL
- Kenol Junior Felix
- Juanita Webb Fico
- Florida Assistant Living Organization, LLC
- Florida Assistant Living Organization, LLC
- Florida Assistant Living Organization, LLC
- James C Flournoy Sr.
- Courtney Strickland Floyd
- Deshala Frazier
- Elizabeth Fulford
- Kimberly Mattair Gallon
All providers in Madison, FL · Public Health or Welfare Agency in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.