NPIMap

Organization Active NPI

Pensacola Primary Care Inc

Doing business as dba Pensacola Primary Care, Inc.-Nine Mile

  • Family Medicine Physician
  • Pensacola, FL
National Provider Identifier
1255320636
Registry record updated Nov 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PENSACOLA PRIMARY CARE INC
Doing business as
dba Pensacola Primary Care, Inc.-Nine Mile
Practice address
1190 E Nine Mile Rd
Pensacola, FL 32514-1651
Phone
(850) 474-8771
Fax
(850) 479-9180
NPI assigned
Oct 18, 2005
Last updated
Nov 7, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2007

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

Authorized official

Name
Mr. Mickey Pickler
Title
Director
Phone
(850) 523-2117

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

1190 E Nine Mile Rd
Pensacola, FL 32514-1651

Mailing address

1190 E Nine Mile Rd
Pensacola, FL 32514-1651
Phone (850) 474-8771

Other names 1

  • dba Pensacola Primary Care, Inc.-Nine Mile Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0886056Pensacola Primary Care Inc1190 E Nine Mile Rd, Pensacola, FL 32514Certificate of waiverMay 11, 2028

National Provider Directory

National Provider Directory
Tax ID family
Pensacola Primary Care Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

NPI Registry JSON

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194393600000",
    "number": "1255320636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1190 E NINE MILE RD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325141651",
            "telephone_number": "850-474-8771",
            "fax_number": "850-479-9180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 E NINE MILE RD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325141651",
            "telephone_number": "850-474-8771",
            "fax_number": "850-479-9180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENSACOLA PRIMARY CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-18",
        "last_updated": "2007-11-07",
        "status": "A",
        "authorized_official_last_name": "PICKLER",
        "authorized_official_first_name": "MICKEY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "850-523-2117",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dba Pensacola Primary Care, Inc.-Nine Mile",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.