Genesis Health and Wellness, LLC

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

Legal business name

GENESIS HEALTH AND WELLNESS, LLC

Doing business as

Premier Interventional Pain Solutions

Practice address

348 Miracle Strip Pkwy SW Ste 16a
Fort Walton Beach, FL 32548-5258

Phone

(850) 200-4353

Fax

(850) 362-6566

NPI assigned

Nov 13, 2018

Last updated

Sep 15, 2026By 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

Kristin Deeken, ACCOUNT MANAGER

Title

CPCS

Phone

(754) 234-8653

Specialties & licenses 2

Addresses

Other names 1

• Premier Interventional Pain Solutions Doing business as

Locations

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

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789430400000",
    "number": "1477022028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "348 MIRACLE STRIP PKWY SW STE 16A",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325485258",
            "telephone_number": "850-200-4353",
            "fax_number": "850-362-6566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "348 MIRACLE STRIP PKWY SW STE 16A",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325485258",
            "telephone_number": "850-200-4353",
            "fax_number": "850-362-6566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS HEALTH AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-13",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A",
        "authorized_official_last_name": "DEEKEN",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "CPCS",
        "authorized_official_telephone_number": "754-234-8653",
        "authorized_official_credential": "ACCOUNT MANAGER"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Interventional Pain Solutions",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Premier Interventional Pain Solutions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ionut Cosmin Gavril
• Nina J. Gawlik, PSY.D.
• Hannah Gaylord, OTR/L
• Natasha Gebhardt
• Amber Mae Gee
• Genesis OBGYN PA
• Genesiscare USA of Florida LLC (Emerald Coast Urology)
• Genesiscare USA of Florida LLC (Basil D Fossum MD)
• Genoa Healthcare LLC
• Amber Lynn Gentry, LMHC

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2026; 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.