Florida Department of Health

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

License

251K00000X Issued in FL

Legal business name

FLORIDA DEPARTMENT OF HEALTH

Doing business as

Gulf County Health Department

Practice address

2475 Garrison Ave
Port St Joe, FL 32456-5265

Phone

(850) 227-1276

Fax

(850) 227-1794

NPI assigned

Feb 6, 2006

Organization subpart

No

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

Authorized official

Name

Douglas Michael Kent, M.P.H.

Title

Chief Operating Officer/Administrat

Phone

(850) 227-1276

Specialties & licenses 1

Addresses

Other identifiers 13

Other names 1

• Gulf County Health Department Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Florida Department of Health

  • Clinical Medical Laboratory
  • Jacksonville, FL
  • NPI 1821023011

  Member Of

  NPD member

Locations

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brittany Jade Beauchamp, APRN

  • Family Nurse Practitioner
  • Port St Joe, FL
  • NPI 1285883918
  Medicare reassignment NPD
• Zhyrma Angelica Monzon Canales

  • Family Nurse Practitioner
  • Tavares, FL
  • NPI 1790261501
  Medicare reassignment NPD
• George Staben Rust, MD

  • Family Medicine Physician
  • Tallahassee, FL
  • NPI 1346376308
  Medicare reassignment NPD
• Andrea Sciberras, D.O.

  • Internal Medicine Physician
  • Dania Beach, FL
  • NPI 1477645661
  Medicare reassignment NPD
• Cathy Lynn Frazier, ARNP

  • Family Nurse Practitioner
  • Albany, OR
  • NPI 1952778839

  FL

  Medicare reassignment NPD
• Misty R Shoemaker, DO

  • Obstetrics & Gynecology Physician
  • Culpeper, VA
  • NPI 1659532661

  FL

  Medicare reassignment NPD

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210809600000",
    "number": "1407828189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2475 GARRISON AVE",
            "city": "PORT ST JOE",
            "state": "FL",
            "postal_code": "324565265",
            "telephone_number": "850-227-1276",
            "fax_number": "850-227-1794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2475 GARRISON AVE",
            "city": "PORT ST JOE",
            "state": "FL",
            "postal_code": "324565265",
            "telephone_number": "850-227-1276",
            "fax_number": "850-227-1794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA DEPARTMENT OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-06",
        "last_updated": "2008-05-15",
        "status": "A",
        "authorized_official_last_name": "KENT",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER/ADMINISTRAT",
        "authorized_official_telephone_number": "850-227-1276",
        "authorized_official_credential": "M.P.H."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "FL",
            "license": "251K00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "027933100",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "027933101",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "027933102",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "027933105",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "027933110",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "027933111",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "027933130",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "027933103",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "027933104",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "027933109",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "027933115",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "027933117",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "027933119",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gulf County Health Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eye Center of North Florida, P.a.
• Daniel Raymond Farrell, M.D.
• Sheila Renee Fennell
• Melissa Sue Finch
• Christine Tracy Fishero-Fazio, BCBA
• Rachel Ashton Forrest, OTR/L
• Patricia A Fults, MDH
• Iris Levon Gathers, CERTIFIED HAIR LOSS
• Geri Care Assisted Living and Rehabilitation Center (Beacon Hill Therapy and Wellness)
• Zoe Gerlach

• Public Health or Welfare Agency in Port St Joe, FL
• Providers in Port St Joe, FL by specialty
• Public Health or Welfare Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.