PHC-Crestview Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

SNF1110096 Issued in FL

Legal business name

PHC-CRESTVIEW INC

Practice address

1849 E First Ave
Crestview, FL 32539-3109

Phone

(850) 682-5322

Fax

(850) 682-5489

NPI assigned

Oct 18, 2005

Organization subpart

Yes

Parent organization

PHC-CRESTVIEW INCAs reported in NPPES

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

Authorized official

Name

Mrs. Catherine A Ates, R.N.

Title

President, Chief Operating Officer

Phone

(850) 682-5322

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

PHC-Crestview Inc

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257984000000",
    "number": "1891784344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 GARDEN GATE CIR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048629",
            "telephone_number": "850-479-1012",
            "fax_number": "850-479-1013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1849 E FIRST AVE",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325393109",
            "telephone_number": "850-682-5322",
            "fax_number": "850-682-5489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHC-CRESTVIEW INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHC-CRESTVIEW INC",
        "enumeration_date": "2005-10-18",
        "last_updated": "2009-11-12",
        "status": "A",
        "authorized_official_last_name": "ATES",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT, CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "850-682-5322",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF1110096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "025110100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shentreda Person, LPN
• Joseph Phillip Peter, MD
• John Stewart Peters, D.O.
• Abbie Petrey
• Julie Ann Petrushak
• Esther Mae Phelps, LMHC
• Pamela Pierce, LCSW
• Elizabeth Rita Pixley, MA, NCC, LMHC, LPC
• Isaac Henry Plummer Jr.
• Stacey Ann Poole, DNP, RN, PMHNP-BC

• Skilled Nursing Facility in Crestview, FL
• Providers in Crestview, FL by specialty
• Skilled Nursing Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2009; 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.