| Crestview Hospital Company Llc | |
|
151 E Redstone Ave Crestview FL 32539-5352 | |
| (850) 689-8100 | |
| Not Available |
| Full Name | Crestview Hospital Company Llc |
|---|---|
| Speciality | Hospitalist |
| Location | 151 E Redstone Ave, Crestview, Florida |
| Authorized Official Name and Position | Kristina Music (DIR, ONBOARDING & PROV ENROLLMENT) |
| Authorized Official Contact | 8778929815 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crestview Hospital Company Llc Po Box 689022 Franklin TN 37068-9022 Ph: (615) 628-6038 | Crestview Hospital Company Llc 151 E Redstone Ave Crestview FL 32539-5352 Ph: (850) 689-8100 |
| NPI Number | 1861441057 |
|---|---|
| Provider Enumeration Date | 05/08/2006 |
| Last Update Date | 11/09/2023 |
| Medicare PECOS PAC ID | 3678472313 |
|---|---|
| Medicare Enrollment ID | O20040123000275 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861441057 | NPI | - | NPPES |
| 267192100 | Medicaid | FL | |
| 34833 | Other | FL | BCBS |
| 40043 | Other | FL | BCBS |
| 40043A | Other | FL | BCBS |
| 660058100 | Medicaid | FL | |
| 660058101 | Medicaid | FL | |
| 529921440 | Medicaid | AL | |
| 660049202 | Medicaid | FL | |
| 660049201 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 208M00000X | Hospitalist | (Florida) | Primary |
| Provider Name | Joseph Pedone |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1093816696 PECOS PAC ID: 9234035940 Enrollment ID: I20031211000704 |
| Provider Name | Hien Ngoc Dao |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1699779389 PECOS PAC ID: 8527965201 Enrollment ID: I20031219000127 |
| Provider Name | Michael Yandel |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1578664140 PECOS PAC ID: 8921080581 Enrollment ID: I20040607000450 |
| Provider Name | Dennis A Stewart |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1053467001 PECOS PAC ID: 4385613009 Enrollment ID: I20041001000260 |
| Provider Name | Ramon L Thigpen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710956867 PECOS PAC ID: 9830191600 Enrollment ID: I20070207000328 |
| Provider Name | Ann Kathryn Gwinnup |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447244223 PECOS PAC ID: 4688624125 Enrollment ID: I20070320000225 |
| Provider Name | Juan C Zarate |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1336134220 PECOS PAC ID: 1355435512 Enrollment ID: I20070919000038 |
| Provider Name | Helen A Preston |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1144320318 PECOS PAC ID: 9830120203 Enrollment ID: I20080426000024 |
| Provider Name | Min Kyung Zimilevich |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750529525 PECOS PAC ID: 5193879104 Enrollment ID: I20090810000553 |
| Provider Name | Michael Gillian Foley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598766180 PECOS PAC ID: 4385773936 Enrollment ID: I20100520000428 |
| Provider Name | Wyslaine Lamontagne |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811182918 PECOS PAC ID: 6103970876 Enrollment ID: I20111205000854 |
| Provider Name | Megumi Maguchi Aldrete |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1417261991 PECOS PAC ID: 2668659491 Enrollment ID: I20120627000615 |
| Provider Name | Reynald Altema |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1548238892 PECOS PAC ID: 3577586890 Enrollment ID: I20120807000813 |
| Provider Name | Brent Hazen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1558591891 PECOS PAC ID: 3072752625 Enrollment ID: I20130612000277 |
| Provider Name | Sarah Ellis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720385412 PECOS PAC ID: 9133359227 Enrollment ID: I20140312000524 |
| Provider Name | Sabeeha F Ahmed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912916909 PECOS PAC ID: 6608870118 Enrollment ID: I20140507001565 |
| Provider Name | Edward Yohanna Salib |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073867941 PECOS PAC ID: 9931418902 Enrollment ID: I20151014002987 |
| Provider Name | Dawn R Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306290606 PECOS PAC ID: 0345533014 Enrollment ID: I20160719001666 |
| Provider Name | Meredith A Flanagan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639549066 PECOS PAC ID: 4981904513 Enrollment ID: I20170718000203 |
| Provider Name | John Myron Faircloth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063543890 PECOS PAC ID: 9537144795 Enrollment ID: I20180601001503 |
| Provider Name | Jacob Randall Lassiter |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1295178580 PECOS PAC ID: 6406087428 Enrollment ID: I20190726000762 |
| Provider Name | Nadine Nguyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104165802 PECOS PAC ID: 6507085727 Enrollment ID: I20210709001893 |
| Provider Name | Thanh Le |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245537489 PECOS PAC ID: 5698950756 Enrollment ID: I20231213000557 |
| Provider Name | David Harrison |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497702302 PECOS PAC ID: 6002985892 Enrollment ID: I20240709004516 |
Crestview Immediate Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4100 S Ferdon Blvd Ste A3, Crestview, FL 32536 Phone: 850-758-7791 | |
Marcene F. Kreifels, M.d., P.a. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1198 S Ferdon Blvd, Crestview, FL 32536 Phone: 850-682-1735 Fax: 850-689-4400 | |
Michael P Roberts Md Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 369 N Main St, Crestview, FL 32536 Phone: 850-398-6963 Fax: 850-398-8277 | |
Panhandle Surgical Institute Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 710 Hospital Dr, Crestview, FL 32539 Phone: 850-398-8480 Fax: 850-398-8482 | |
Advanced Family Medicine Clinic Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 327 Medcrest Drive, Unit A, Crestview, FL 32536 Phone: 850-423-0761 Fax: 855-793-3568 | |
North Florida Medical Centers Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 800 Hospital Dr, Crestview, FL 32539 Phone: 850-682-1164 Fax: 850-682-5302 | |
Abdul B Mir Md Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 131 E Redstone Ave, Suite 101, Crestview, FL 32539 Phone: 850-682-5174 Fax: 850-689-3653 |