Twin Cities Primary Care- Destin LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

TWIN CITIES PRIMARY CARE- DESTIN LLC

Practice address

12272 Emerald Coast Parkway
Destin, FL 32550

Phone

(850) 269-0662

Fax

(850) 269-0745

NPI assigned

Apr 16, 2007

Last updated

Feb 17, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Mickey Pickler

Title

Vice President

Phone

(850) 523-2117

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Calvin L Blount Jr., M.D.

  • Family Medicine Physician
  • Destin, FL
  • NPI 1164404588
  NPD (past)
• Anthony V Lanasa, MD

  • Family Medicine Physician
  • Destin, FL
  • NPI 1447245105
  NPD (past)

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266364800000",
    "number": "1437374212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12272 EMERALD COAST PARKWAY",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "32550",
            "telephone_number": "850-269-0662",
            "fax_number": "850-269-0745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12272 EMERALD COAST PARKWAY",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "32550",
            "telephone_number": "850-269-0662",
            "fax_number": "850-269-0745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWIN CITIES PRIMARY CARE- DESTIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2010-02-17",
        "status": "A",
        "authorized_official_last_name": "PICKLER",
        "authorized_official_first_name": "MICKEY",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "850-523-2117",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Tison
• Rhonda Marie Tolbert, RN
• Ashiah M Tolliver
• Sara Tolson
• Joseph Tully
• Michelle Ann Underwood, LMHC, MCAP
• Kassi Vanderploeg, BCBA
• Julie Vanhusan, LPTA
• Angel R Vasquez, DMD
• Amanda Nicholle Vaughn, COTA/L

• Family Medicine Physician in Destin, FL
• Providers in Destin, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.