| Jason Qualley, MD, CCP,LP | |
|
182 E Redstone Ave Ste A, Crestview, FL 32539-5371 | |
| (855) 527-7246 | |
| (833) 905-2461 |
| Full Name | Jason Qualley |
|---|---|
| Gender | Male |
| Speciality | Hospitalist |
| Experience | 7 Years |
| Location | 182 E Redstone Ave Ste A, Crestview, Florida |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215432901 | NPI | - | NPPES |
| 121439800 | Medicaid | FL |
| Facility Name | Location | Facility Type |
|---|---|---|
| Lee Memorial Hospital | Fort myers, FL | Hospital |
| North Okaloosa Medical Center | Crestview, FL | Hospital |
| Sacred Heart Hospital On The Emerald Coast | Miramar beach, FL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Gulf Coast Pain Consultants Llc | 1658516570 | 31 |
| Lee Health System Inc | 9335672146 | 1153 |
| Entity Name | Lee Memorial Health System |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1992873319 PECOS PAC ID: 8729996608 Enrollment ID: O20031118000604 |
| Entity Name | Gulf Coast Pain Consultants Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1669712287 PECOS PAC ID: 1658516570 Enrollment ID: O20130326000183 |
| Entity Name | Lee Health System Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1942058557 PECOS PAC ID: 9335672146 Enrollment ID: O20241114001576 |
| Mailing Address | Practice Location Address |
|---|---|
| Jason Qualley, MD, CCP,LP 201 Defense Hwy Ste 205, Annapolis, MD 21401-7096 Ph: (855) 527-7246 | Jason Qualley, MD, CCP,LP 182 E Redstone Ave Ste A, Crestview, FL 32539-5371 Ph: (855) 527-7246 |
Donald Dyrone Chipman Jr., MD Pain Medicine Medicare: Accepting Medicare Assignments Practice Location: 150 E Redstone Ave Ste A, Crestview, FL 32539 Phone: 504-752-6688 Fax: 850-475-2669 | |
David Allen Norfleet, DO Pain Medicine Medicare: Not Enrolled in Medicare Practice Location: 150 E Redstone Ave, Suite A, Crestview, FL 32539 Phone: 850-689-8004 Fax: 850-689-8068 |