Active NPI
Mary Jo Pace, CST, SA
- General Acute Care Hospital
- Destin, FL
National Provider Identifier
1386007227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Acute Care Hospital
- License
- 131323
- Practice address
- 4 Rue D Etretat
Destin, FL 32541-2239 - Phone
- (256) 541-4660
- NPI assigned
- Mar 29, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | 131323 | FL | Primary |
Addresses
Primary practice location
4 Rue D Etretat
Destin, FL 32541-2239
Mailing address
4 Rue D Etretat
Destin, FL 32541-2239
Phone (256) 541-4660
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 131323 | FL | MD | General Acute Care Hospital |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459209600000",
"number": "1386007227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 RUE D ETRETAT",
"city": "DESTIN",
"state": "FL",
"postal_code": "325412239",
"telephone_number": "256-541-4660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 RUE D ETRETAT",
"city": "DESTIN",
"state": "FL",
"postal_code": "325412239",
"telephone_number": "256-541-4660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PACE",
"first_name": "MARY",
"middle_name": "JO",
"credential": "CST, SA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-03-29",
"last_updated": "2016-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "282N00000X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital",
"state": "FL",
"license": "131323",
"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 Mar 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.