NPIMap

Organization Active NPI

Dynamic Pain & Wellness LLC

  • Anesthesiology Physician
  • Fort Walton Beach, FL
National Provider Identifier
1285007989
Registry record updated May 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
DYNAMIC PAIN & WELLNESS LLC
Practice address
930 Marwalt Dr, Unit C
Fort Walton Beach, FL 32547-6706
Phone
(850) 226-6801
Fax
(877) 413-5104
NPI assigned
Nov 4, 2015
Last updated
May 8, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2026

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

Authorized official

Name
Dr. Mathew McCune, MDNPI 1457493611
Title
Ceo
Phone
(850) 502-3310

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X Primary

Addresses

Primary practice location

930 Marwalt Dr, Unit C
Fort Walton Beach, FL 32547-6706

Mailing address

930 Marwalt Drive
Suite C
Fort Walton Beach, FL 32547
Phone (850) 226-6801

Other names 1

  • Dynamic Pain & Wellness PLLC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, AL3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20160310000011 FL Part B Supplier - Clinic/Group Practice 8527364058 Receives reassigned benefits from 27 practitioners
Practice locations: Crestview, FL; Destin, FL; Fort Walton Beach, FL; Milton, FL; Panama City, FL; Pensacola, FL
O20160722002420 FL DME Supplier - Physician - Interventional Pain Management 8527364058 Practice locations: Fort Walton Beach, FL
O20181012001431 AL Part B Supplier - Clinic/Group Practice 8527364058 Receives reassigned benefits from 14 practitioners
Practice locations: Dothan, AL; Mobile, AL

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

2826 Ross Clark Cir
Ste 103
Dothan, AL 36301
Phone (251) 308-9800

1924K Dauphin Island Pkwy
Unit C
Mobile, AL 36605

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

2110 W 23rd St
Panama City, FL 32405
Phone (850) 769-3398

1851 Saint Mary Ave
Pensacola, FL 32501

5111 N 12th Ave
Unit B
Pensacola, FL 32504

325 John Knox Rd
Tallahassee, FL 32303
Phone (850) 688-5213

325 John Knox Rd
Bldg 200
Tallahassee, FL 32303

Practitioners & affiliated clinicians

Practitioners 46

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.

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1446595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778198400000",
    "number": "1285007989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 MARWALT DRIVE",
            "address_2": "SUITE C",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "32547",
            "telephone_number": "850-226-6801",
            "fax_number": "877-413-5104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 MARWALT DR, UNIT C",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476706",
            "telephone_number": "850-226-6801",
            "fax_number": "877-413-5104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC PAIN & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-04",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "status": "A",
        "authorized_official_last_name": "MCCUNE",
        "authorized_official_first_name": "MATHEW",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "850-502-3310",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dynamic Pain & Wellness PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Fort Walton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.