NPIMap

Organization Active NPI

Florida Department of Health

  • Public Health or Welfare Agency
  • Marianna, FL
National Provider Identifier
1487724969
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
License
ME86600 Issued in FL
Legal business name
FLORIDA DEPARTMENT OF HEALTH
Practice address
4979 Healthy Way
Marianna, FL 32446-7993
Phone
(850) 526-2412
Fax
(850) 718-0383
NPI assigned
Nov 9, 2006
Organization subpart
Yes
Parent organization
FLORIDA DEPARTMENT OF HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Authorized official

Name
Mrs. Susannah Culbreath
Title
Billing Administrator
Phone
(850) 526-2412

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health & General Preventive Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2083P0901X ME86600 FL
Public Health or Welfare Agency 251K00000X ME86600 FL Primary

Addresses

Primary practice location

4979 Healthy Way
Marianna, FL 32446-7993

Mailing address

4979 Healthy Way
PO Box 310
Marianna, FL 32446-7993
Phone (850) 526-2412

Other identifiers 2

IdentifierTypeStateIssuer
027942100MedicaidFL
97896OtherFLBCBS

Other names 1

  • Jackson County Health Department Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090414000118 FL Part B Supplier - Public Health/Welfare Agency 3072424282 Receives reassigned benefits from 2 practitioners
Practice locations: Marianna, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0677280Jackson County Health Department4979 Healthy Way, Marianna, FL 32446Provider-performed microscopyJan 8, 2027

National Provider Directory

National Provider Directory
Tax ID family
Dept of Health Central Pharmacy185 organizations share this tax ID, including this one
Part of
Dept of Health Central Pharmacy

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Walton Community Health CenterDefuniak Springs, FL, CCN 101136 Federally qualified health center Operational/Managerial Control (100%) Sep 7, 2010
Bradford Community Health Care IncStarke, FL, CCN 101182 Federally qualified health center Operational/Managerial Control (100%) Oct 1, 2013

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728864000000",
    "number": "1487724969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4979 HEALTHY WAY",
            "address_2": "PO BOX 310",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324467993",
            "telephone_number": "850-526-2412",
            "fax_number": "850-718-0383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4979 HEALTHY WAY",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324467993",
            "telephone_number": "850-526-2412",
            "fax_number": "850-718-0383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA DEPARTMENT OF HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FLORIDA DEPARTMENT OF HEALTH",
        "enumeration_date": "2006-11-09",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A",
        "authorized_official_last_name": "CULBREATH",
        "authorized_official_first_name": "SUSANNAH",
        "authorized_official_title_or_position": "BILLING ADMINISTRATOR",
        "authorized_official_telephone_number": "850-526-2412",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "FL",
            "license": "ME86600",
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "FL",
            "license": "ME86600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "027942100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "97896",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jackson County Health Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marianna, FL

Sources for this page

Verify at the official NPI Registry.