Jesse Walck, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

ME88530 Issued in FL

Practice address

5151 North 9TH Ave
Pensacola, FL 32513-2699

Phone

(850) 416-7710

Fax

(850) 416-7677

NPI assigned

May 23, 2006

Last updated

Mar 4, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Cep America, LLC

  • Emergency Medicine Physician
  • Miramar Beach, FL
  • NPI 1295442614
  Medicare reassignment NPD
• Panhandle Emergency Physicians a Div of Sacred Heart Hosp Pensacola

  dba Panhandle Emergency Physicians

  • Emergency Medicine Physician
  • Pensacola, FL
  • NPI 1215948096
  Medicare reassignment NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Port St Joe, FL
  • NPI 1588426076
  NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1700747946
  NPD
• Sacred Heart Health System, Inc.

  dba Ascension Medical Group Sacred Heart

  • Family Medicine Physician
  • Pensacola, FL
  • NPI 1144271586
  NPD
• Inphynet Contracting Services LLC

  • Emergency Medicine Physician
  • Delray Beach, FL
  • NPI 1073556767
  NPD (past)
• SCHC Pediatric Associates, LLC

  • Pediatrics Physician
  • Philadelphia, PA
  • NPI 1255363578
  NPD (past)

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1487609913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2699",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325132699",
            "telephone_number": "850-475-4500",
            "fax_number": "850-475-4619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5151 NORTH 9TH AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325132699",
            "telephone_number": "850-416-7710",
            "fax_number": "850-416-7677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALCK",
        "first_name": "JESSE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME88530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "268184600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores East, LP (Vision Center 30-1222)
• Wal-Mart Stores East, LP (Vision Center 30-1224)
• Wal-Mart Stores East, LP (Vision Center 30-3785)
• Wal-Mart Stores East, LP (Vision Center 30-3484)
• Wal-Mart Stores East, LP (Vision Center 30-1605)
• James M Waldorf, PA-C
• Megan Elizabeth Waldron, ARNP
• Walgreen Co (Walgreens #10181)
• Walgreen Co (Walgreens #05659)
• Walgreen Co (Walgreens #09916)

• Emergency Medicine Physician in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Emergency Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.