Crestview Health And Wellness Center Llc is a medicare enrolled "Nurse Practitioner - Primary Care" provider in Crestview, Florida. Their current practice location is
596 N Ferdon Blvd, Crestview, Florida. You can reach out to their office (for appointments etc.) via phone at
(850) 306-3268.
Crestview Health And Wellness Center Llc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Crestview Health And Wellness Center Llc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1811425002.
Healthcare Provider's Profile
| Full Name | Crestview Health And Wellness Center Llc |
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| Type | Facility |
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| Speciality | Nurse Practitioner - Primary Care |
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| Location | 596 N Ferdon Blvd, Crestview, Florida |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1811425002
- Provider Enumeration Date: 06/01/2017
- Last Update Date: 05/23/2025
Medicare PECOS Information:
- PECOS PAC ID: 9638613599
- Enrollment ID: O20240702002585
Medical Identifiers
Medical identifiers for Crestview Health And Wellness Center Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1811425002 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 111N00000X | Chiropractor | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 363LW0102X | Nurse Practitioner - Women's Health | (* (Not Available)) | Secondary |
| 363LP2300X | Nurse Practitioner - Primary Care | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Crestview Health And Wellness Center Llc acts as a billing entity for following providers:
| Provider Name | Connie R Killam |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1033427406
PECOS PAC ID: 5991985855
Enrollment ID: I20110209000676 |
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| Provider Name | David Scott Rawson |
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| Provider Type | Practitioner - Chiropractic |
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| Provider Identifiers | NPI Number: 1689118218
PECOS PAC ID: 4284994625
Enrollment ID: I20180205001056 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Crestview Health And Wellness Center Llc is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Crestview Health And Wellness Center Llc
596 N Ferdon Blvd,
Crestview, FL 32536-2753
Ph: (850) 478-1312 | Crestview Health And Wellness Center Llc
596 N Ferdon Blvd,
Crestview, FL 32536-2753
Ph: (850) 306-3268 |
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