NPIMap

Organization Active NPI

Crestview Hospital Corporation

  • Orthopaedic Surgery Physician
  • Crestview, FL
National Provider Identifier
1851570071
Registry record updated Mar 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
CRESTVIEW HOSPITAL CORPORATION
Practice address
550 Redstone Ave W
Suite 370
Crestview, FL 32536-6428
Phone
(850) 423-0061
NPI assigned
Oct 25, 2007
Last updated
Mar 18, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2022

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

Authorized official

Name
Jennifer L Jackson
Title
Sr Dir Onboarding & Prov Enrollment
Phone
(615) 465-3334

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X Primary

Addresses

Primary practice location

550 Redstone Ave W
Suite 370
Crestview, FL 32536-6428

Mailing address

7100 Commerce Way
Suite 180
Brentwood, TN 37027-2829
Phone (615) 465-7626

National Provider Directory

National Provider Directory
Tax ID family
Northokaloosa Med Ctr E9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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": "1193270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647561600000",
    "number": "1851570071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7100 COMMERCE WAY",
            "address_2": "SUITE 180",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370272829",
            "telephone_number": "615-465-7626",
            "fax_number": "615-465-3007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 REDSTONE AVE W",
            "address_2": "SUITE 370",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325366428",
            "telephone_number": "850-423-0061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTVIEW HOSPITAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-25",
        "last_updated": "2022-03-18",
        "certification_date": "2022-02-14",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SR DIR ONBOARDING & PROV ENROLLMENT",
        "authorized_official_telephone_number": "615-465-3334"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestview, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2022; 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.