Individual provider Active NPI

Alexcia Dawn Pennell, CNM, FNP-C

  • Advanced Practice Midwife
  • Fort Walton Beach, FL
National Provider Identifier
1407249691
Registry record updated Jan 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
APRN11021829 Issued in FL
Practice address
1046 Mar Walt Dr # 200
Fort Walton Beach, FL 32547-6645
Phone
(850) 243-2229
NPI assigned
Mar 11, 2015
Last updated
Jan 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X APRN11021829 FL Primary
Family Nurse Practitioner 363LF0000X APRN11021829 FL

Addresses

Primary practice location

1046 Mar Walt Dr # 200
Fort Walton Beach, FL 32547-6645

Mailing address

1046 Mar Walt Dr # 200
Fort Walton Beach, FL 32547-6645
Phone (850) 243-2229

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230103000099 FL Practitioner - Certified Nurse Midwife (CNM) 7315265816 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Diana Health FL, PAGroup PAC ID 5092253245, 33 clinicians
North Okaloosa Clinic CorpGroup PAC ID 0244205565, 27 clinicians

Practice addresses (Care Compare)

1046 Mar Walt Dr
Suite 200
Fort Walton Beach, FL 32547-6645
Phone (850) 243-2229

550 Redstone Ave W
Suite 490
Crestview, FL 32536-6457
Phone (850) 689-8321

550 Redstone W Ave
Crestview, FL 32536-6457

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.8 of 100Reported as apm
Quality
77.6
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
632NCMDAcupuncturist
APRN11021829FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Diana Health FL P.a. Family CurrentSince Feb 6, 2026 Accepting new patients
North Okaloosa Clinic Corp CurrentSince Oct 16, 2023 Accepting new patients
North Okaloosa Clinic Corp CurrentSince Oct 16, 2023 Accepting new patients
Absolute OBGYN LLC PastSince Feb 6, 2026 Accepting new patients

Locations

151 E Redstone Ave
Crestview, FL 32539
Phone (850) 629-8515

400 Redstone Ave W
Crestview, FL 32536
Phone (850) 683-1555

550 Redstone Ave W
Crestview, FL 32536
Phone (850) 306-2552

550 Redstone Ave W
Ste 470
Crestview, FL 32536
Phone (850) 689-2223

1046 Mar Walt Dr
Ste 200
Fort Walton Beach, FL 32547
Phone (850) 243-2229

1507 Merchants Way
Ste A
Niceville, FL 32578
Phone (850) 897-3600

330 Franklin Rd
Ste 135A
Brentwood, TN 37027
Phone (615) 727-0177

Interoperability endpoints

  • Direct secure messaging: alexcia.pennell.1@1523.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/23211/brand/1/csg/21/fhir/r4

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1426032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768348800000",
    "number": "1407249691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1046 MAR WALT DR # 200",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476645",
            "telephone_number": "850-243-2229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1046 MAR WALT DR # 200",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476645",
            "telephone_number": "850-243-2229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNELL",
        "first_name": "ALEXCIA",
        "middle_name": "DAWN",
        "credential": "CNM, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-11",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "FL",
            "license": "APRN11021829",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11021829",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

Verify at the official NPI Registry.