Organization Active NPI

Destin Primary Care LLC

  • Family Medicine Physician
  • Destin, FL
National Provider Identifier
1275601023
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DESTIN PRIMARY CARE LLC
Practice address
996 Airport Rd
Suite E 103
Destin, FL 32541-2824
Phone
(850) 837-5562
Fax
(850) 837-6085
NPI assigned
Dec 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jo Lucido
Title
Office Manager
Phone
(850) 837-5562

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

996 Airport Rd
Suite E 103
Destin, FL 32541-2824

Mailing address

996 Airport Rd
Destin, FL 32541-2824
Phone (850) 837-5562

National Provider Directory

National Provider Directory

Locations

996 Airport Rd
Ste E103
Destin, FL 32541
Phone (850) 837-5562

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275601023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "996 AIRPORT RD",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325412824",
            "telephone_number": "850-837-5562",
            "fax_number": "850-837-6085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "996 AIRPORT RD",
            "address_2": "SUITE E 103",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325412824",
            "telephone_number": "850-837-5562",
            "fax_number": "850-837-6085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESTIN PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LUCIDO",
        "authorized_official_first_name": "JO",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "850-837-5562"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Destin, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.