Individual provider Active NPI

Briana Rae Toothaker, FNP

  • Family Nurse Practitioner
  • Fort Walton Beach, FL
National Provider Identifier
1598515355
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11042188 Issued in FL
Practice address
350G Racetrack Rd NW
Fort Walton Beach, FL 32547-1699
Phone
(850) 374-3125
Fax
(850) 226-5544
NPI assigned
Mar 25, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2024004878 MO
Family Nurse Practitioner 363LF0000X APRN11042188 FL Primary

Addresses

Primary practice location

350G Racetrack Rd NW
Fort Walton Beach, FL 32547-1699

Mailing address

350G Racetrack Rd NW
Fort Walton Beach, FL 32547-1699
Phone (850) 374-3125

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240402002557 MO Order and Referring Only - Nurse Practitioner 1355789983

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

30 Hammock Oaks Blvd
Freeport, FL 32439-2898

PO Box
Suite 16309
Jacksonville, FL 32245

PO Box
Suite 3466
Charleston, WV 25334

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2024004878MOMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1711324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1598515355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350G RACETRACK RD NW",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325471699",
            "telephone_number": "850-374-3125",
            "fax_number": "850-226-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350G RACETRACK RD NW",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325471699",
            "telephone_number": "850-374-3125",
            "fax_number": "850-226-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOOTHAKER",
        "first_name": "BRIANA",
        "middle_name": "RAE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-25",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2024004878",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11042188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

Verify at the official NPI Registry.