NPIMap

Organization Active NPI

Northwest Florida Healthcare, Inc

Doing business as Northwest Florida Medical Group

  • Pediatrics Physician
  • Chipley, FL
National Provider Identifier
1851458962
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
NORTHWEST FLORIDA HEALTHCARE, INC
Doing business as
Northwest Florida Medical Group
Practice address
1360 Brickyard Rd
Chipley, FL 32428-6303
Phone
(850) 638-1610
Fax
(850) 638-5764
NPI assigned
Jan 2, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Gregg Moreau
Title
Cfo & Coo
Phone
(850) 415-8197

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU
Pediatrics Physician 208000000X NU Primary
Surgery Physician 208600000X NU

Addresses

Primary practice location

1360 Brickyard Rd
Chipley, FL 32428-6303

Mailing address

1360 Brickyard Rd
Chipley, FL 32428-6303
Phone (850) 638-1610

Other names 1

  • Northwest Florida Medical Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Northwest Florida Healthcare Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1851458962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 BRICKYARD RD",
            "city": "CHIPLEY",
            "state": "FL",
            "postal_code": "324286303",
            "telephone_number": "850-638-1610",
            "fax_number": "850-638-5764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 BRICKYARD RD",
            "city": "CHIPLEY",
            "state": "FL",
            "postal_code": "324286303",
            "telephone_number": "850-638-1610",
            "fax_number": "850-638-5764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST FLORIDA HEALTHCARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "MOREAU",
        "authorized_official_first_name": "GREGG",
        "authorized_official_title_or_position": "CFO & COO",
        "authorized_official_telephone_number": "850-415-8197"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northwest Florida Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chipley, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.