Panhandle Rural Health & Primary Care Inc

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

PANHANDLE RURAL HEALTH & PRIMARY CARE INC

Practice address

20274 Central Ave W
Blountstown, FL 32424-1957

Phone

(850) 353-7689

Fax

(850) 674-8889

NPI assigned

Jan 28, 2020

Last updated

Feb 9, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ronald Gilbert Watson Jr., APRNNPI 1780062604

Title

Owner/Provider

Phone

(850) 353-7689

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1588295752. Details of each certification follow.

• CCN 683837 Rural health clinic · Active · Details

Rural health clinic certification: CCN 683837

Legal name

PANHANDLE RURAL HEALTH & PRIMARY CARE INC

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Nov 20, 2020

Last certification

Nov 20, 2020

Ownership / control type

1B

Organization structure

CorporationProprietary

Incorporated

Feb 1, 2020 in FL

Enrollment address

20274 Central Ave W
Blountstown, FL 32424-1957

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21096/brand/1/csg/1/fhir/r4

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Ronald Gilbert Watson Jr., APRN/CRNA

  • Certified Registered Nurse Anesthetist
  • Blountstown, FL
  • NPI 1780062604

  5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, W-2 Managing Employee

  CMS ownership

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ronald Gilbert Watson Jr., APRN/CRNA

  • Certified Registered Nurse Anesthetist
  • Blountstown, FL
  • NPI 1780062604

  Family Medicine

  Medicare reassignment Care Compare group NPD Authorized official
• Garrett H Chumney, M.D.

  • Family Medicine Physician
  • Tallahassee, FL
  • NPI 1871657957
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1580169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707436800000",
    "number": "1588295752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20274 CENTRAL AVE W",
            "city": "BLOUNTSTOWN",
            "state": "FL",
            "postal_code": "324241957",
            "telephone_number": "850-353-7689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20274 CENTRAL AVE W",
            "city": "BLOUNTSTOWN",
            "state": "FL",
            "postal_code": "324241957",
            "telephone_number": "850-353-7689",
            "fax_number": "850-674-8889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANHANDLE RURAL HEALTH & PRIMARY CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-28",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "GILBERT",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "850-353-7689",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110740900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nieves Home Care Transportation LLC
• Kelsey Odom
• Pancare of Florida, Inc (Golden Pharmacy)
• Pancare of Florida, Inc
• Panhandle Home Care
• Panhandle Therapy Center LLC
• Panhandle Therapy Center LLC
• Panhandle Therapy Center LLC
• Linda Ann Patnode, LMHC
• Verna L Patterson-Roberts, MASTERS

• Rural Health Clinic/Center in Blountstown, FL
• Providers in Blountstown, FL by specialty
• Rural Health Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.