Individual provider Active NPI

Michael Blocker

  • Family Nurse Practitioner
  • Navarre, FL
National Provider Identifier
1487134052
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
24411 Issued in TN
Practice address
8990 Navarre Pkwy
Navarre, FL 32566-2216
Phone
(850) 396-0108
NPI assigned
Aug 14, 2018
Last updated
Jan 29, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 24411 TN Primary

Addresses

Primary practice location

8990 Navarre Pkwy
Navarre, FL 32566-2216

Mailing address

8990 Navarre Pkwy
Navarre, FL 32566-2216
Phone (850) 396-0108

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180927000716 TN Practitioner - Nurse Practitioner 5698026862 Reassigns benefits to 2 organizations
I20240228001459 FL Practitioner - Nurse Practitioner 5698026862 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
White-Wilson Medical Center PAGroup PAC ID 4082510607, 48 clinicians

Practice addresses (Care Compare)

8990 Navarre Pkwy
Navarre, FL 32566-2216
Phone (850) 396-0108

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
24411TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Medical Clinic PLLC CurrentSince Aug 1, 2018 Accepting new patients
Maury Regional Medical Group, Inc Family CurrentSince Sep 1, 2019 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Aug 1, 2018 Accepting new patients
White-Wilson Medical Center PA CurrentSince Mar 1, 2024 Accepting new patients
Maury Regional Hospital Marshall Medical Center CurrentSince Sep 1, 2019 Accepting new patients

Locations

1005 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 863-8100

8990 Navarre Pkwy
Navarre, FL 32566
Phone (850) 396-0108

1218 Trotwood Ave
Columbia, TN 38401
Phone (931) 380-4114

1222 Trotwood Ave
Ste 603
Columbia, TN 38401
Phone (931) 381-3872

854 W James M Campbell Blvd
Ste 303
Columbia, TN 38401
Phone (931) 388-8779

543 E Main St
Hohenwald, TN 38462
Phone (931) 295-3547

Interoperability endpoints

  • Direct secure messaging: michael.blocker.1@21123.direct.athenahealth.com

Organizations & group practices 6

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 3

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": "1534204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1487134052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8990 NAVARRE PKWY",
            "city": "NAVARRE",
            "state": "FL",
            "postal_code": "325662216",
            "telephone_number": "850-396-0108",
            "fax_number": "833-450-5239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8990 NAVARRE PKWY",
            "city": "NAVARRE",
            "state": "FL",
            "postal_code": "325662216",
            "telephone_number": "850-396-0108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOCKER",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-14",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "24411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Navarre, FL

Sources for this page

Verify at the official NPI Registry.