Individual provider Active NPI

Thea Katherine Nobles, PA-C

  • Physician Assistant
  • Pensacola, FL
National Provider Identifier
1275293086
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1851 Saint Mary Ave
Pensacola, FL 32501-1053
Phone
(850) 226-6801
Fax
(877) 413-5104
NPI assigned
Dec 20, 2021
Last updated
Sep 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1851 Saint Mary Ave
Pensacola, FL 32501-1053

Mailing address

PO Box 100174
Columbia, SC 29202-3174
Phone (864) 512-6140

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230926000395 FL Practitioner - Physician Assistant 7416341169 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Florida Surgeons PAGroup PAC ID 2769381391, 336 clinicians

Practice addresses (Care Compare)

11945 San Jose Blvd
Jacksonville, FL 32223-1627
Phone (904) 396-1725

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.79 of 100Reported as group
Quality
64.42
Promoting interoperability
100
Improvement activities
40
Cost
74.88

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4262SCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Dynamic Pain & Wellness LLC CurrentSince Oct 9, 2023 Accepting new patients
North Florida Surgeons, PA CurrentSince May 6, 2024 Accepting new patients
North Florida Surgeons, PA CurrentSince May 6, 2024 Accepting new patients

Locations

930 Mar Walt Dr
Fort Walton Beach, FL 32547
Phone (850) 331-2930

930 Mar Walt Dr
Unit C
Fort Walton Beach, FL 32547
Phone (850) 431-6183

11945 San Jose Blvd
Ste 102
Jacksonville, FL 32223
Phone (904) 268-3937

11945 San Jose Blvd
Ste 300
Jacksonville, FL 32223

1851 Saint Mary Ave
Pensacola, FL 32501

4012 N 9th Ave
Pensacola, FL 32503
Phone (850) 444-4777

Interoperability endpoints

  • Direct secure messaging: thea.nobles.1@9109.direct.athenahealth.com
  • Direct secure messaging: tnobles51005@direct.anmedhealth.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1639958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1275293086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100174",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292023174",
            "telephone_number": "864-512-6140",
            "fax_number": "864-512-6149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1851 SAINT MARY AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325011053",
            "telephone_number": "850-226-6801",
            "fax_number": "877-413-5104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOBLES",
        "first_name": "THEA",
        "middle_name": "KATHERINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-20",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.