Active NPI
Rodney E Powell MD PA
- Cardiovascular Disease Physician
- Fort Walton Beach, FL
National Provider Identifier
1619904059
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- ME0038630
- Legal business name
- RODNEY E POWELL MD PA
- Practice address
- 965 Mar Walt Dr
Fort Walton Beach, FL 32547-6759 - Phone
- (850) 862-6934
- NPI assigned
- Jun 28, 2006
- Reactivated
- Mar 22, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Marilyn Oest
- Title
- Office Manager
- Phone
- (850) 862-6934
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | ME0038630 | FL | Primary |
Addresses
Primary practice location
965 Mar Walt Dr
Fort Walton Beach, FL 32547-6759
Mailing address
965 Mar Walt Dr
Fort Walton Beach, FL 32547-6759
Phone (850) 862-6934
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821063959 | Other | FL | INDIVIDUAL NPI |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Cardiovascular Disease Physician
- Ft Walton Beach, FL
- NPI 1821063959
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151452800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1279584000000",
"number": "1619904059",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "965 MAR WALT DR",
"city": "FORT WALTON BEACH",
"state": "FL",
"postal_code": "325476759",
"telephone_number": "850-862-6934"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "965 MAR WALT DR",
"city": "FORT WALTON BEACH",
"state": "FL",
"postal_code": "325476759",
"telephone_number": "850-862-6934"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RODNEY E POWELL MD PA",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-28",
"last_updated": "2010-07-20",
"deactivation_date": "2007-09-05",
"reactivation_date": "2010-03-22",
"status": "A",
"authorized_official_last_name": "OEST",
"authorized_official_first_name": "MARILYN",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "850-862-6934"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "FL",
"license": "ME0038630",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDIVIDUAL NPI",
"identifier": "1821063959",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fort Walton Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.