NPIMap

Organization Active NPI

Northwest Florida Primary Care LLC

  • Hospitalist Physician
  • Niceville, FL
National Provider Identifier
1740429679
Registry record updated Nov 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
Legal business name
NORTHWEST FLORIDA PRIMARY CARE LLC
Practice address
4400 E Highway 20 Ste 203
Niceville, FL 32578-7700
Phone
(850) 897-3678
Fax
(850) 897-3708
NPI assigned
Feb 17, 2009
Last updated
Nov 10, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2017

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

Authorized official

Name
John Mark Rodkey
Title
Vice President
Phone
(850) 523-3816

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208M00000X FL Primary

Addresses

Primary practice location

4400 E Highway 20 Ste 203
Niceville, FL 32578-7700

Mailing address

2000 Health Park Dr
Brentwood, TN 37027-4525
Phone (615) 372-5426

National Provider Directory

National Provider Directory

Locations

4418 Commons Dr E
Destin, FL 32541
Phone (850) 650-3148

4400 E Highway 20
Niceville, FL 32578
Phone (850) 279-4104

4400 E Highway 20
Ste 203204
Niceville, FL 32578

Practitioners & affiliated clinicians

Practitioners 32

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 32

NPI Registry JSON

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

{
    "created_epoch": "1234828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510272000000",
    "number": "1740429679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 HEALTH PARK DR",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274525",
            "telephone_number": "615-372-5426",
            "fax_number": "866-831-4898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 E HIGHWAY 20 STE 203",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325787700",
            "telephone_number": "850-897-3678",
            "fax_number": "850-897-3708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST FLORIDA PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-17",
        "last_updated": "2017-11-10",
        "status": "A",
        "authorized_official_last_name": "RODKEY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "850-523-3816"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niceville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2017; 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.