Individual provider Active NPI

Robert Clark Sledge Jr., MD

  • Obstetrics & Gynecology Physician
  • Niceville, FL
National Provider Identifier
1508123829
Registry record updated Aug 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME136689 Issued in FL
Practice address
4586 E Highway 20 Ste a
Niceville, FL 32578-9724
Phone
(850) 897-0110
Fax
(850) 897-1626
NPI assigned
Apr 12, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME136689 FL Primary

Addresses

Primary practice location

4586 E Highway 20 Ste a
Niceville, FL 32578-9724

Mailing address

PO Box 2699
Pensacola, FL 32513-2699
Phone (850) 475-4500

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20181108002180 FL Practitioner - Obstetrics/Gynecology 0648563486 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of South Alabama College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sacred Heart Health System IncGroup PAC ID 3779491386, 373 clinicians

Practice addresses (Care Compare)

4586 E Hwy 20
Suite a
Niceville, FL 32578-9802
Phone (850) 987-0110

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME136689FLMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Health System, Inc. CurrentSince Aug 1, 2018 Accepting new patients
Sacred Heart Health System, Inc. Current Accepting new patients
Sacred Heart Health System Inc CurrentSince Aug 1, 2018 Accepting new patients

Locations

36500 Emerald Coast Pkwy
Destin, FL 32541
Phone (850) 269-0301

4586 E Highway 20
Ste A
Niceville, FL 32578
Phone (850) 897-0110

Interoperability endpoints

  • Direct secure messaging: robert.sledge.1@9582.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1334188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533513600000",
    "number": "1508123829",
    "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": "4586 E HIGHWAY 20 STE A",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325789724",
            "telephone_number": "850-897-0110",
            "fax_number": "850-897-1626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLEDGE",
        "first_name": "ROBERT",
        "middle_name": "CLARK",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-12",
        "last_updated": "2018-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME136689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niceville, FL

Sources for this page

Verify at the official NPI Registry.