Organization Active NPI

Rodney E Powell MD PA

  • Cardiovascular Disease Physician
  • Fort Walton Beach, FL
National Provider Identifier
1619904059
Registry record updated Jul 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
ME0038630 Issued in FL
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

Updated by the provider on Jul 20, 2010

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)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
1821063959OtherFLINDIVIDUAL NPI

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.

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.

Verify at the official NPI Registry.