Organization Active NPI

Panhandle Family Care Associates Inc

  • Family Medicine Physician
  • Marianna, FL
National Provider Identifier
1598930679
Registry record updated Aug 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PANHANDLE FAMILY CARE ASSOCIATES INC
Practice address
4284 Kelson Ave
Marianna, FL 32446-2948
Phone
(850) 482-2910
Fax
(850) 482-2836
NPI assigned
Apr 29, 2008
Last updated
Aug 20, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2015

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

Authorized official

Name
John A SpenceNPI 1497794796
Title
MD
Phone
(850) 482-2910

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

4284 Kelson Ave
Marianna, FL 32446-2948

Mailing address

4284 Kelson Ave
Marianna, FL 32446-2948
Phone (850) 482-2910

Other identifiers 4

IdentifierTypeStateIssuer
DA3069OtherMEDICARE RAILROAD
34321OtherFLBLUECROSS BLUESHIELD FLORIDA
276272200MedicaidFL
AT785OtherFLMEDICARE PTAN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440028800000",
    "number": "1598930679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4284 KELSON AVE",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324462948",
            "telephone_number": "850-482-2910",
            "fax_number": "850-482-2836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4284 KELSON AVE",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324462948",
            "telephone_number": "850-482-2910",
            "fax_number": "850-482-2836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANHANDLE FAMILY CARE ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-29",
        "last_updated": "2015-08-20",
        "status": "A",
        "authorized_official_last_name": "SPENCE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "850-482-2910"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DA3069",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD FLORIDA",
            "identifier": "34321",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "276272200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "AT785",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marianna, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.