NPIMap

Organization Active NPI

Atwood and Clark Associates, LLC

Doing business as Midway Medical Clinic II

  • General Practice Physician
  • Panama City, FL
National Provider Identifier
1285038117
Registry record updated Oct 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME108352 Issued in FL
Legal business name
ATWOOD AND CLARK ASSOCIATES, LLC
Doing business as
Midway Medical Clinic II
Practice address
201 Forest Park Cir
Panama City, FL 32405-4916
Phone
(850) 248-7777
Fax
(850) 248-7779
NPI assigned
Oct 21, 2014
Last updated
Oct 21, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2014

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

Authorized official

Name
Mr. Raun D Skyrm
Title
Administrator
Phone
(330) 773-3544

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ME108352 FL Primary

Addresses

Primary practice location

201 Forest Park Cir
Panama City, FL 32405-4916

Mailing address

201 Forest Park Cir
Panama City, FL 32405-4916
Phone (850) 248-7777

Other names 1

  • MIDWAY MEDICAL CLINIC II Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141202000503 FL Part B Supplier - Clinic/Group Practice 1557683521 Receives reassigned benefits from 12 practitioners
Practice locations: Panama City, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1413849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413849600000",
    "number": "1285038117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 FOREST PARK CIR",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054916",
            "telephone_number": "850-248-7777",
            "fax_number": "850-248-7779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 FOREST PARK CIR",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054916",
            "telephone_number": "850-248-7777",
            "fax_number": "850-248-7779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATWOOD AND CLARK ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-21",
        "last_updated": "2014-10-21",
        "status": "A",
        "authorized_official_last_name": "SKYRM",
        "authorized_official_first_name": "RAUN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "330-773-3544",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME108352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MIDWAY MEDICAL CLINIC II",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Panama City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2014; 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.