Healthmark of Walton Inc

Primary specialty

Rural Acute Care HospitalTaxonomy code 282NR1301X

License

4234 Issued in FL

Legal business name

HEALTHMARK OF WALTON INC

Practice address

4413 US Highway 331 S
Defuniak Springs, FL 32435-6307

Phone

(850) 951-4500

Fax

(850) 892-7079

NPI assigned

Jun 30, 2005

Organization subpart

No

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

Authorized official

Name

Ms. Lisa Shirley Holley

Title

Coo

Phone

(850) 951-4500

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Healthmark Regional Medical Center Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Hospital certification: CCN 100081

Legal name

HEALTHMARK REGIONAL MEDICAL CENTER

Certification status

Terminated Voluntary: merger or closure, May 3, 2023

Provider type (POS)

Hospital – Short-term

Participating since

Jul 1, 1966

Last certification

Jul 9, 2021

Beds

50

Ownership / control type

Private (for profit)

Facility address

4413 US Hwy 331 S
Defuniak Springs, FL 32435

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632700800000",
    "number": "1710984299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4413 US HIGHWAY 331 S",
            "city": "DEFUNIAK SPRINGS",
            "state": "FL",
            "postal_code": "324356307",
            "telephone_number": "850-951-4500",
            "fax_number": "850-892-7079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4413 US HIGHWAY 331 S",
            "city": "DEFUNIAK SPRINGS",
            "state": "FL",
            "postal_code": "324356307",
            "telephone_number": "850-951-4500",
            "fax_number": "850-892-7079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHMARK OF WALTON INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-30",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A",
        "authorized_official_last_name": "HOLLEY",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "SHIRLEY",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "850-951-4500",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": "FL",
            "license": "4234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010188500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healthmark Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Healthmark Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gulf Coast Pain Consultants LLC
• Benjamin Fredrick Hammett, P.T
• Wendy M Harris, FNP-C
• Arjan Hayer
• Kerrian A Hazley, MD
• Healthmark of Walton Inc.
• Healthmark of Walton Rural Health Clinic Inc
• Healthy Transitions, LLC
• Lauran L Hebert
• Melinda C. Henderson, ARNP, FAAN,

• Rural Acute Care Hospital in Defuniak Springs, FL
• Providers in Defuniak Springs, FL by specialty
• Rural Acute Care Hospital in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.