Organization Active NPI

William Abernathy MD PA

  • Internal Medicine Physician
  • Niceville, FL
National Provider Identifier
1902970197
Registry record updated Nov 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME63600 Issued in FL
Legal business name
WILLIAM ABERNATHY MD PA
Practice address
4566 E Highway 20
Ste. 105
Niceville, FL 32578-8838
Phone
(850) 897-0030
NPI assigned
Nov 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2007

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

Authorized official

Name
William Abernathy, M. D.
Title
Director
Phone
(850) 897-0030

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X ME63600 FL Primary

Addresses

Primary practice location

4566 E Highway 20
Ste. 105
Niceville, FL 32578-8838

Mailing address

4566 E Highway 20
Ste. 105
Niceville, FL 32578-8838
Phone (850) 897-0030

Other identifiers 1

IdentifierTypeStateIssuer
25152OtherFLBCBS

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195776000000",
    "number": "1902970197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4566 E HIGHWAY 20",
            "address_2": "STE. 105",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325788838",
            "telephone_number": "850-897-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4566 E HIGHWAY 20",
            "address_2": "STE. 105",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325788838",
            "telephone_number": "850-897-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM ABERNATHY MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-11-23",
        "status": "A",
        "authorized_official_last_name": "ABERNATHY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "850-897-0030",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME63600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "25152",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Niceville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2007; 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.