Pensacola Health Trust Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

391 Issued in MS

Legal business name

PENSACOLA HEALTH TRUST INC

Doing business as

The Boyington

Practice address

1530 Broad Ave
Gulfport, MS 39501-3601

Phone

(228) 864-6544

Fax

(228) 868-8544

NPI assigned

Aug 22, 2005

Organization subpart

No

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

Authorized official

Name

Scott Bell

Title

Ceo President

Phone

(850) 430-0000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Boyington Doing business as

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356333629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 N PALAFOX ST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325025631",
            "telephone_number": "850-430-0000",
            "fax_number": "850-436-6766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 BROAD AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395013601",
            "telephone_number": "228-864-6544",
            "fax_number": "228-868-8544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENSACOLA HEALTH TRUST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BELL",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "CEO PRESIDENT",
        "authorized_official_telephone_number": "850-430-0000"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MS",
            "license": "391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0230108",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Boyington",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Susannah Brooke Peleaz, P-LPC
• David Shane Pendley, M.D.
• Jesse Pullen Penico, MD
• Chancelyn S Penn, CNP
• Lauren Penny, SLP
• Roy D Pepper Jr., DC
• Perez Vision Clinic
• Jeffrey J Perez, O.D.
• Carolyn Marie Peters, FNP-C
• Carolyn Patricia Peters, OTR/L

• Skilled Nursing Facility in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Skilled Nursing Facility in Mississippi

• 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.