Active NPI
Jon Gilbert Hebblewhite, D.O.
- Family Medicine Physician
- Bunnell, FL
National Provider Identifier
1508974346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 053102
- Practice address
- 4489 Clove Avenue
Bunnell, FL 32110-5241 - Phone
- (813) 503-6789
- Fax
- (813) 932-5389
- NPI assigned
- Aug 29, 2006
- Last updated
- Mar 3, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 053102 | FL | Primary |
Addresses
Primary practice location
4489 Clove Avenue
Bunnell, FL 32110-5241
Mailing address
4489 Clove Avenue
Bunnell, FL 32110-5241
Phone (813) 503-6789
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 053102 | FL | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677801600000",
"number": "1508974346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4489 CLOVE AVENUE",
"city": "BUNNELL",
"state": "FL",
"postal_code": "321105241",
"telephone_number": "813-503-6789",
"fax_number": "813-932-5389"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4489 CLOVE AVENUE",
"city": "BUNNELL",
"state": "FL",
"postal_code": "321105241",
"telephone_number": "813-503-6789",
"fax_number": "813-932-5389"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEBBLEWHITE",
"first_name": "JON",
"middle_name": "GILBERT",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-29",
"last_updated": "2023-03-03",
"certification_date": "2023-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "053102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bunnell, FL
- Deborah A Frazer, ARNP
- Brittany C Gaskin, APRN
- Melissa Celene Guarnieri, REGISTERED NURSE
- Misty Lynn Hamling
- Ashley Jessica Harris, APRN
- Helping Hands of Flagler County, LLC
- Helping Hands of Flagler County, LLC
- Helping Hands of Flagler County, LLC
- Helping Hands of Flagler County, LLC
- Wendy Louise Hicks
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2023; 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.