Individual provider Active NPI

John Dudley, M.D.

  • Interventional Cardiology Physician
  • Fort Walton Beach, FL
National Provider Identifier
1679923254
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
ME162979 Issued in FL
Practice address
320 Racetrack Rd NW Ste 100D
Fort Walton Beach, FL 32547-1796
Phone
(448) 202-6100
Fax
(448) 202-6101
NPI assigned
Jun 15, 2016
Last updated
Nov 18, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X ME162979 FL Primary
Cardiovascular Disease Physician 207RC0000X ME162979 FL
Internal Medicine Physician 207R00000X LP03806 RI

Addresses

Primary practice location

320 Racetrack Rd NW Ste 100D
Fort Walton Beach, FL 32547-1796

Mailing address

320 Racetrack Rd NW Ste 100D
Fort Walton Beach, FL 32547-1796
Phone (448) 202-6100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230803000177 FL Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 9739474842 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology), Internal Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Okaloosa Cardiology PAGroup PAC ID 7315920899, 9 clinicians
Northwest Florida Multispecialty Physicians LLCGroup PAC ID 5597801779, 16 clinicians

Practice addresses (Care Compare)

129 E Redstone Ave
Suite a
Crestview, FL 32539-5350
Phone (850) 682-7212

320 Racetrack Rd NW
Suite 100D
Fort Walton Beach, FL 32547-1796
Phone (444) 202-6100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.55 of 100Reported as group
Quality
68.18
Improvement activities
40
Cost
78.15

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting32

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Florida Multispecialty Physicians LLC CurrentSince Oct 1, 2025 Accepting new patients
Okaloosa Cardiology P a Cardiovascular Disease CurrentSince Jul 24, 2023 Accepting new patients

Locations

129 E Redstone Ave
Ste A
Crestview, FL 32539
Phone (850) 682-7212

320 Racetrack Rd NW
Ste 100D
Fort Walton Beach, FL 32547
Phone (444) 202-6100

921 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 388-4333

1032 Mar Walt Dr
Unit 110
Ft Walton Bch, FL 32547
Phone (850) 862-1753

1032 Mar Walt Dr
Unit 230
Ft Walton Bch, FL 32547
Phone (850) 862-3194

Interoperability endpoints

  • Direct secure messaging: john.dudley@hca5.eclinicaldirectplus.com
  • Direct secure messaging: jbdudley@yourcarecommunity.org
  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/0009543
  • Direct secure messaging: johndudley@ocfl.allscriptsdirect.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1465948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1679923254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 RACETRACK RD NW STE 100D",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325471796",
            "telephone_number": "448-202-6100",
            "fax_number": "448-202-6101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 RACETRACK RD NW STE 100D",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325471796",
            "telephone_number": "448-202-6100",
            "fax_number": "448-202-6101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDLEY",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-15",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "FL",
            "license": "ME162979",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME162979",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "LP03806",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

Verify at the official NPI Registry.