NPIMap

Organization Active NPI

West Florida Internal Medicine LLC

  • Internal Medicine Physician
  • Pensacola, FL
National Provider Identifier
1679555833
Registry record updated Feb 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
WEST FLORIDA INTERNAL MEDICINE LLC
Practice address
2120 E Johnson Ave
Pensacola, FL 32514-6028
Phone
(850) 494-3218
Fax
(866) 390-1343
NPI assigned
Nov 15, 2005
Last updated
Feb 8, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2012

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

Authorized official

Name
Mrs. Larissa McCarthy
Title
Office Manager
Phone
(850) 494-3218

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary
Obstetrics & Gynecology Physician 207V00000X
Physical Medicine & Rehabilitation Physician 208100000X
Hospitalist Physician 208M00000X

Addresses

Primary practice location

2120 E Johnson Ave
Pensacola, FL 32514-6028

Mailing address

2120 E Johnson Ave
Pensacola, FL 32514-6028
Phone (850) 494-3218

Other identifiers 1

IdentifierTypeStateIssuer
276659100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060213000253 FL Part B Supplier - Clinic/Group Practice 7214942283 Receives reassigned benefits from 9 practitioners
Practice locations: Fort Walton Beach, FL; Pace, FL; Pensacola, FL

National Provider Directory

National Provider Directory

Locations

4244 Avalon Blvd
Milton, FL 32583
Phone (448) 227-5750

2120 E Johnson Ave
Pensacola, FL 32514
Phone (850) 494-4885

8333 N Davis Hwy
Fl 7
Pensacola, FL 32514
Phone (850) 474-1625

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 23

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.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328659200000",
    "number": "1679555833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 E JOHNSON AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325146028",
            "telephone_number": "850-494-3218",
            "fax_number": "866-390-1343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 E JOHNSON AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325146028",
            "telephone_number": "850-494-3218",
            "fax_number": "866-390-1343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST FLORIDA INTERNAL MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-15",
        "last_updated": "2012-02-08",
        "status": "A",
        "authorized_official_last_name": "MCCARTHY",
        "authorized_official_first_name": "LARISSA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "850-494-3218",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "276659100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.