Journeypure Fort Walton

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

License

0146AD9349-01 Issued in FL

Legal business name

JOURNEYPURE FORT WALTON

Practice address

907 Mar Walt Dr
Suite 2013
Fort Walton Beach, FL 32547-6960

Phone

(850) 249-4300

NPI assigned

Apr 8, 2015

Organization subpart

No

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

Authorized official

Name

Patrick Dunn, MS ICADC

Title

Vice President

Phone

(502) 472-3728

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1428451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428451200000",
    "number": "1528454352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 PENN WARREN DR",
            "address_2": "SUITE 300-290",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275047",
            "telephone_number": "615-727-8386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 MAR WALT DR",
            "address_2": "SUITE 2013",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476960",
            "telephone_number": "850-249-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOURNEYPURE FORT WALTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-08",
        "last_updated": "2015-04-08",
        "status": "A",
        "authorized_official_last_name": "DUNN",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "502-472-3728",
        "authorized_official_credential": "MS ICADC"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "FL",
            "license": "0146AD9349-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Jones
• Michael Cody Jones
• Sara Elaine Jones
• Vincent Thomas Jones, MD
• Joseph R Agostinelli DPM PA
• Ashley Bates Joyner, M.S., CCC-SLP
• Yelda Jozaghi
• Anthony Jason Juliano, PHARMD
• Cornelia Denise Justice, RN
• Robert Brian Justice, ARNP

• Substance Use Disorder Rehabilitation Clinic/Center in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.