NPIMap

Organization Active NPI

Pensacola Primary Care Inc

  • Family Medicine Physician
  • Milton, FL
National Provider Identifier
1992828818
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PENSACOLA PRIMARY CARE INC
Practice address
5942 Berryhill Rd
Milton, FL 32570-4009
Phone
(850) 981-9340
Fax
(850) 626-7882
NPI assigned
Apr 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mickey Pickler
Title
VP
Phone
(850) 523-2117

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

5942 Berryhill Rd
Milton, FL 32570-4009

Mailing address

5942 Berryhill Rd
Milton, FL 32570-4009
Phone (850) 981-9340

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040126000626 FL Part B Supplier - Clinic/Group Practice 6002718343 Receives reassigned benefits from 29 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pensacola, FL; Pace, FL

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Locations

2130 E Johnson Ave
Ste 120
Pensacola, FL 32514
Phone (850) 332-6339

Practitioners & affiliated clinicians

Practitioners 29

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 29

NPI Registry JSON

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

{
    "created_epoch": "1175904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992828818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5942 BERRYHILL RD",
            "city": "MILTON",
            "state": "FL",
            "postal_code": "325704009",
            "telephone_number": "850-981-9340",
            "fax_number": "850-626-7882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5942 BERRYHILL RD",
            "city": "MILTON",
            "state": "FL",
            "postal_code": "325704009",
            "telephone_number": "850-981-9340",
            "fax_number": "850-626-7882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENSACOLA PRIMARY CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PICKLER",
        "authorized_official_first_name": "MICKEY",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "850-523-2117"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.