Our Lady of Angels, St. Joseph Medical Clinic, Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

OUR LADY OF ANGELS, ST. JOSEPH MEDICAL CLINIC, INC

Practice address

131 W. Intendencia St.
Pensacola, FL 32502

Phone

(850) 434-8162

Fax

(850) 434-8996

NPI assigned

Aug 28, 2013

Organization subpart

No

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

Authorized official

Name

Dr. David Conkle, M.D.

Title

Medical Director

Phone

(850) 434-8162

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Peter Christian Delevett, M.D.

  • General Practice Physician
  • Pensacola, FL
  • NPI 1871831958
  NPD (past)

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

{
    "created_epoch": "1377648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377820800000",
    "number": "1831523612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 W. INTENDENCIA ST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "32502",
            "telephone_number": "850-434-8162",
            "fax_number": "850-434-8996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 W. INTENDENCIA ST.",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "32502",
            "telephone_number": "850-434-8162",
            "fax_number": "850-434-8996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUR LADY OF ANGELS, ST. JOSEPH MEDICAL CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-28",
        "last_updated": "2013-08-30",
        "status": "A",
        "authorized_official_last_name": "CONKLE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "850-434-8162",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Todd Graham Osborne, D.O.
• Danielle Nicole Ostrowski, ARNP
• Hannah Nicole Otoole, BCBA
• Bailey Paige Ouellette, DO
• Wayne Cary Ouellette, PTA
• Robin Michelle Overbay, PA-C
• Kendra Overfield, OTR/L
• Stella Ruth Overholt X
• Krystal S. Overly, ARNP
• Paige A Overstreet, M.S.,CCC-SLP

• Primary Care Clinic/Center in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2013; 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.