Fort Walton Open Radiology, PLLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

FORT WALTON OPEN RADIOLOGY, PLLC

Doing business as

Open MRI of Fort Walton

Practice address

908 Mar Walt Dr
Fort Walton Beach, FL 32547-6706

Phone

(850) 862-9394

NPI assigned

Nov 14, 2019

Organization subpart

No

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

Authorized official

Name

Ross W Barnett, MD

Title

Owner

Phone

(850) 862-9394

Specialties & licenses 1

Addresses

Other names 1

• Open MRI of Fort Walton Doing business as

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

{
    "created_epoch": "1573689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573689600000",
    "number": "1710522602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 242848",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361242848",
            "telephone_number": "334-270-9914",
            "fax_number": "334-270-3195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 MAR WALT DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476706",
            "telephone_number": "850-862-9394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT WALTON OPEN RADIOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-14",
        "last_updated": "2019-11-14",
        "status": "A",
        "authorized_official_last_name": "BARNETT",
        "authorized_official_first_name": "ROSS",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-862-9394",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Open MRI of Fort Walton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• David Fortner, L.M.H.C.
• Cierra Fortson
• Jennifer Lynn Fortune
• Basil D. Fossum

• Diagnostic Radiology Physician in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Diagnostic Radiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2019; 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.