Organization Active NPI

Northwest Florida Cardiology LLC

  • Cardiovascular Disease Physician
  • Niceville, FL
National Provider Identifier
1295719037
Registry record updated May 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
NORTHWEST FLORIDA CARDIOLOGY LLC
Practice address
490 Highway 85 N
Ste a & B
Niceville, FL 32578-1010
Phone
(850) 678-6501
Fax
(850) 678-6516
NPI assigned
Dec 5, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2010

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

490 Highway 85 N
Ste a & B
Niceville, FL 32578-1010

Mailing address

490 Highway 85 N
Ste a & B
Niceville, FL 32578-1010
Phone (850) 678-6501

Other identifiers 1

IdentifierTypeStateIssuer
DF1366OtherFLRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

101 Hart St
Niceville, FL 32578
Phone (850) 729-1800

490 Highway 85 N
#B
Niceville, FL 32578
Phone (850) 678-6501

Practitioners & affiliated clinicians

Practitioners 1

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": "1133740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273449600000",
    "number": "1295719037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "490 HIGHWAY 85 N",
            "address_2": "STE A & B",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325781010",
            "telephone_number": "850-678-6501",
            "fax_number": "850-678-6516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 HIGHWAY 85 N",
            "address_2": "STE A & B",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325781010",
            "telephone_number": "850-678-6501",
            "fax_number": "850-678-6516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST FLORIDA CARDIOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-05",
        "last_updated": "2010-05-10",
        "status": "A",
        "authorized_official_last_name": "PICKLER",
        "authorized_official_first_name": "MICKEY",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "850-523-2117",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DF1366",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Niceville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2010; 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.