NPIMap

Organization Active NPI

Floridian Hospitalist Services, LLC

  • Hospitalist Physician
  • Crestview, FL
National Provider Identifier
1881049997
Registry record updated Jan 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
Legal business name
FLORIDIAN HOSPITALIST SERVICES, LLC
Practice address
151 E Redstone Ave
Crestview, FL 32539-5352
Phone
(850) 689-8100
NPI assigned
Apr 26, 2016
Last updated
Jan 20, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2020

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

Authorized official

Name
Kim H Larsen
Title
Director of Credentialing
Phone
(770) 874-5468

Specialties & licenses 1

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

Addresses

Primary practice location

151 E Redstone Ave
Crestview, FL 32539-5352

Mailing address

PO Box 21201
Belfast, ME 04915-4109
Phone (770) 874-5400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140128001837 FL Part B Supplier - Clinic/Group Practice 8527297217 Receives reassigned benefits from 91 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Crestview, FL

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 65

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 65

NPI Registry JSON

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

{
    "created_epoch": "1461628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579478400000",
    "number": "1881049997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21201",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154109",
            "telephone_number": "770-874-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 E REDSTONE AVE",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325395352",
            "telephone_number": "850-689-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDIAN HOSPITALIST SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-26",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A",
        "authorized_official_last_name": "LARSEN",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING",
        "authorized_official_telephone_number": "770-874-5468"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "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 Jan 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.