| Primary Care South, Inc | |
|
5551 Us Highway 98 Santa Rosa Beach FL 32459 | |
| (850) 420-5420 | |
| (850) 244-8011 |
| Full Name | Primary Care South, Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5551 Us Highway 98, Santa Rosa Beach, Florida |
| Authorized Official Name and Position | Kimmie Hunter (CREDENTIAL) |
| Authorized Official Contact | 8504205420 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Care South, Inc 5551 Us Highway 98 Santa Rosa Beach FL 32459 Ph: (850) 420-5420 | Primary Care South, Inc 5551 Us Highway 98 Santa Rosa Beach FL 32459 Ph: (850) 420-5420 |
| NPI Number | 1093356685 |
|---|---|
| Provider Enumeration Date | 10/04/2019 |
| Last Update Date | 10/10/2022 |
| Medicare PECOS PAC ID | 6406282300 |
|---|---|
| Medicare Enrollment ID | O20200213001222 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093356685 | NPI | - | NPPES |
| 104684300 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Benjamin L Stalnaker |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1821105479 PECOS PAC ID: 8628015567 Enrollment ID: I20050413000094 |
| Provider Name | Michael T Patton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245200633 PECOS PAC ID: 8820002686 Enrollment ID: I20200213001282 |
| Provider Name | Lynde Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063953339 PECOS PAC ID: 7214205319 Enrollment ID: I20200930000640 |
| Provider Name | Matthew Patton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548872567 PECOS PAC ID: 7214357763 Enrollment ID: I20201021003154 |
| Provider Name | Rachael Arnett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326639162 PECOS PAC ID: 2567871411 Enrollment ID: I20210506001067 |
| Provider Name | Morris Cochran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861432296 PECOS PAC ID: 9830170281 Enrollment ID: I20210507000601 |
| Provider Name | Veronica Rodriguez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982164075 PECOS PAC ID: 6901273408 Enrollment ID: I20221111001340 |
| Provider Name | Kaitlyn Connor Matheney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689242463 PECOS PAC ID: 4284030073 Enrollment ID: I20230306000929 |
| Provider Name | Caroline Mcdowell Hydrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316723299 PECOS PAC ID: 4880043629 Enrollment ID: I20231206000190 |
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