Niceville Primary Care Bluewater

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

NICEVILLE PRIMARY CARE BLUEWATER

Practice address

4400 E Highway 20
Suite 203
Niceville, FL 32578-8779

Phone

(850) 897-3678

Fax

(850) 897-3708

NPI assigned

Oct 4, 2006

Organization subpart

No

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

Authorized official

Name

Mickey Pickler

Title

VP

Phone

(850) 523-2117

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190937600000",
    "number": "1457446387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 E HIGHWAY 20",
            "address_2": "SUITE 203",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325788779",
            "telephone_number": "850-897-3678",
            "fax_number": "850-897-3708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 E HIGHWAY 20",
            "address_2": "SUITE 203",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325788779",
            "telephone_number": "850-897-3678",
            "fax_number": "850-897-3708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICEVILLE PRIMARY CARE BLUEWATER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-09-28",
        "status": "A",
        "authorized_official_last_name": "PICKLER",
        "authorized_official_first_name": "MICKEY",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "850-523-2117"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Marie Nelson
• Neuroway TMS
• Niceville Family Dental Center, P.L.
• Niceville Family Practice LLC
• Niceville General Surgery LLC
• Niceville Urgent Care LLC
• Amanda Nielsen, LCSW
• Molly Marie Nixon, PA
• Lincoln Norris
• North Florida Surgeons, PA

• Family Medicine Physician in Niceville, FL
• Providers in Niceville, 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 Sep 28, 2007; 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.