NPIMap

Organization Active NPI

Nemours Children's Health, Fort Walton Beach, Specialty Care

  • Multi-Specialty Clinic/Center
  • Fort Walton Beach, FL
National Provider Identifier
1902474240
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
NEMOURS CHILDREN'S HEALTH, FORT WALTON BEACH, SPECIALTY CARE
Practice address
341 Racetrack Rd NW
Fort Walton Beach, FL 32547-1787
Phone
(850) 505-4700
NPI assigned
Jun 14, 2021
Last updated
Jun 14, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
THE NEMOURS FOUNDATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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

Authorized official

Name
Rodney Aaron McKendree
Title
VP, Finance
Phone
(904) 697-5648

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

341 Racetrack Rd NW
Fort Walton Beach, FL 32547-1787

Mailing address

10140 Centurion Pkwy N
Jacksonville, FL 32256-0532

National Provider Directory

National Provider Directory
Tax ID family
Nemours Children's Health Fort Walton Beach Specialty Care75 organizations share this tax ID, including this one
Part of
Nemours Children's Health Fort Walton Beach Specialty Care

Organizations with this tax ID in the same state 16

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623628800000",
    "number": "1902474240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10140 CENTURION PKWY N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322560532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 RACETRACK RD NW",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325471787",
            "telephone_number": "850-505-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEMOURS CHILDREN'S HEALTH, FORT WALTON BEACH, SPECIALTY CARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE NEMOURS FOUNDATION",
        "enumeration_date": "2021-06-14",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A",
        "authorized_official_last_name": "MCKENDREE",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_middle_name": "AARON",
        "authorized_official_title_or_position": "VP, FINANCE",
        "authorized_official_telephone_number": "904-697-5648"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; 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.