| Santa Rosa Hma Physician Management, Llc | |
|
4225 Woodbine Rd Suite A Milton FL 32571-8790 | |
| (850) 994-6575 | |
| (850) 994-2806 |
| Full Name | Santa Rosa Hma Physician Management, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 4225 Woodbine Rd, Milton, Florida |
| Authorized Official Name and Position | Jennifer L Jackson (SENIOR DIRECTOR PROVIDER ENROLLMENT) |
| Authorized Official Contact | 6154653334 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Santa Rosa Hma Physician Management, Llc Po Box 689022 Franklin TN 37068-9022 Ph: () - | Santa Rosa Hma Physician Management, Llc 4225 Woodbine Rd Suite A Milton FL 32571-8790 Ph: (850) 994-6575 |
| NPI Number | 1447365366 |
|---|---|
| Provider Enumeration Date | 08/20/2006 |
| Last Update Date | 03/16/2022 |
| Medicare PECOS PAC ID | 1658478532 |
|---|---|
| Medicare Enrollment ID | O20070823000556 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447365366 | NPI | - | NPPES |
| 374819701 | Medicaid | FL |
| Provider Name | Angelo Marcus Mishio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962453969 PECOS PAC ID: 7113831587 Enrollment ID: I20031119000042 |
| Provider Name | Tonya Lynn Freeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982673018 PECOS PAC ID: 5991772881 Enrollment ID: I20040910000943 |
| Provider Name | Thomas Riney |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1457341307 PECOS PAC ID: 6901863307 Enrollment ID: I20041217000122 |
| Provider Name | Martha J Stewart |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1588664809 PECOS PAC ID: 1850347501 Enrollment ID: I20050420000886 |
| Provider Name | Dennis U Atienza |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1225038235 PECOS PAC ID: 3375579253 Enrollment ID: I20050713000121 |
| Provider Name | Amy N Stone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346214145 PECOS PAC ID: 1254341811 Enrollment ID: I20060426000555 |
| Provider Name | Edward Wesley Bisher |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1215995386 PECOS PAC ID: 9133169394 Enrollment ID: I20060725000377 |
| Provider Name | Lisa M Della Ratta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649203126 PECOS PAC ID: 5496843385 Enrollment ID: I20071109000375 |
| Provider Name | Thomas V Messe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366422784 PECOS PAC ID: 3476625245 Enrollment ID: I20080710000676 |
| Provider Name | Lorrie A Knapp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316198609 PECOS PAC ID: 2163587189 Enrollment ID: I20090206000558 |
| Provider Name | Shane A Adkison |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659319515 PECOS PAC ID: 8325104201 Enrollment ID: I20090227000532 |
| Provider Name | Cindy J Harris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427064666 PECOS PAC ID: 0446156111 Enrollment ID: I20100119000551 |
| Provider Name | Jenny A West |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174842009 PECOS PAC ID: 7911039680 Enrollment ID: I20100715000324 |
| Provider Name | Peter M Szymoniak |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1073510095 PECOS PAC ID: 5698883726 Enrollment ID: I20101102001552 |
| Provider Name | Michael W Barber |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1801984091 PECOS PAC ID: 0244427151 Enrollment ID: I20101203001130 |
| Provider Name | Sue George |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1053340679 PECOS PAC ID: 7113115825 Enrollment ID: I20101222000434 |
| Provider Name | Debra L Hemphill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902895394 PECOS PAC ID: 2062600281 Enrollment ID: I20110103000439 |
| Provider Name | Lloyd W Sloan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750351136 PECOS PAC ID: 0244410231 Enrollment ID: I20110208000843 |
| Provider Name | Mohamed Badr Sultan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1154522175 PECOS PAC ID: 6305934696 Enrollment ID: I20110414000257 |
| Provider Name | Edwin E Taylor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790765915 PECOS PAC ID: 6901080969 Enrollment ID: I20110415000362 |
| Provider Name | Michael P Levaugh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992091631 PECOS PAC ID: 3173793247 Enrollment ID: I20110826000693 |
| Provider Name | Ellen J Esses |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1316975055 PECOS PAC ID: 9931272887 Enrollment ID: I20120223000390 |
| Provider Name | Asser El-atfy |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1710985239 PECOS PAC ID: 4688603988 Enrollment ID: I20120307000261 |
| Provider Name | Christine Tenniswood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841241429 PECOS PAC ID: 9739217969 Enrollment ID: I20120627000345 |
| Provider Name | Alicia Crane |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619311461 PECOS PAC ID: 6204075732 Enrollment ID: I20130613000437 |
| Provider Name | Casey L. Schneider |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780018853 PECOS PAC ID: 0840424222 Enrollment ID: I20131018000893 |
| Provider Name | Joan M Mosher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134534589 PECOS PAC ID: 5294952347 Enrollment ID: I20140813001301 |
| Provider Name | Krista S Silverman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497912471 PECOS PAC ID: 7719156140 Enrollment ID: I20150223000825 |
| Provider Name | Bobby J Simpson |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1972555852 PECOS PAC ID: 4981637733 Enrollment ID: I20150518002213 |
| Provider Name | Melissa Crumley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760864854 PECOS PAC ID: 5496064495 Enrollment ID: I20151014000205 |
| Provider Name | Todd Prochnow |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1932103983 PECOS PAC ID: 0749233559 Enrollment ID: I20151027000670 |
| Provider Name | Jessica C Royce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609244383 PECOS PAC ID: 4284934969 Enrollment ID: I20151202001057 |
| Provider Name | Daniel Fitzpatrick |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1891879284 PECOS PAC ID: 4183805872 Enrollment ID: I20151209000174 |
| Provider Name | Van Brandon Foles |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1134550056 PECOS PAC ID: 8022248426 Enrollment ID: I20160924000229 |
| Provider Name | Ricardo Mohammed |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1275844870 PECOS PAC ID: 5890008718 Enrollment ID: I20161020000777 |
| Provider Name | Andrew I Horowitz |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1336337591 PECOS PAC ID: 0547404402 Enrollment ID: I20170221000182 |
| Provider Name | Shannan M Ward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902346794 PECOS PAC ID: 0941587034 Enrollment ID: I20170427000214 |
| Provider Name | Tiffany S Cook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487189023 PECOS PAC ID: 6305114752 Enrollment ID: I20170608000236 |
| Provider Name | Sarah L Skelly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881013886 PECOS PAC ID: 9032482666 Enrollment ID: I20170901002811 |
| Provider Name | Mary A Cross |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1366858672 PECOS PAC ID: 3779840798 Enrollment ID: I20171129003364 |
| Provider Name | Heather Elizabeth Waters |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700197977 PECOS PAC ID: 8426295296 Enrollment ID: I20171205001684 |
| Provider Name | Cameron Townsend Corte |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083034888 PECOS PAC ID: 8123381563 Enrollment ID: I20180417001070 |
| Provider Name | Robert Dimick |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1346212602 PECOS PAC ID: 5294632014 Enrollment ID: I20180514001820 |
| Provider Name | Tracey Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437519618 PECOS PAC ID: 8224317300 Enrollment ID: I20181129003114 |
| Provider Name | Erwin Bennett |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1811216518 PECOS PAC ID: 6507159373 Enrollment ID: I20181219002264 |
| Provider Name | Tavaris R Brooks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609359868 PECOS PAC ID: 5496091720 Enrollment ID: I20190108001758 |
| Provider Name | Danielle N Ostrowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770074536 PECOS PAC ID: 6103162144 Enrollment ID: I20190111000369 |
| Provider Name | Devonn L Bourg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467919928 PECOS PAC ID: 1759615651 Enrollment ID: I20190626003239 |
| Provider Name | Naomi Golino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538644257 PECOS PAC ID: 5597096404 Enrollment ID: I20191008000731 |
| Provider Name | Tyler Hamilton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265856819 PECOS PAC ID: 4183994882 Enrollment ID: I20200811000345 |
| Provider Name | Genevieve H Hinks |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1982086013 PECOS PAC ID: 3375852551 Enrollment ID: I20210126001848 |
| Provider Name | Dessie Elaine Walimaa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033700299 PECOS PAC ID: 3173931383 Enrollment ID: I20210427002290 |
| Provider Name | Paul Alappat |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1801970645 PECOS PAC ID: 9931119930 Enrollment ID: I20210824002829 |
| Provider Name | Jessica E Rife |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538734181 PECOS PAC ID: 5294133021 Enrollment ID: I20211008002250 |
| Provider Name | Merlandie Etienne Houston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538746599 PECOS PAC ID: 3577958164 Enrollment ID: I20220317001112 |
| Provider Name | Emily J Fletcher |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1558707752 PECOS PAC ID: 4385872985 Enrollment ID: I20220414001064 |
| Provider Name | Alex Robert Stahura |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649697632 PECOS PAC ID: 1759680176 Enrollment ID: I20220902001736 |
| Provider Name | Tanya Nicole Slayter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316410236 PECOS PAC ID: 4284975681 Enrollment ID: I20221204000000 |
| Provider Name | Julie Elizabeth Howell-clemmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699482141 PECOS PAC ID: 1759756299 Enrollment ID: I20230414000030 |
| Provider Name | Erin Lind |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669839932 PECOS PAC ID: 1658678107 Enrollment ID: I20230527000064 |
| Provider Name | Jennifer Suzanne Pearcy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932899820 PECOS PAC ID: 7911367263 Enrollment ID: I20230718002186 |
| Provider Name | Alyssa Sheedlo |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1215634225 PECOS PAC ID: 5193189124 Enrollment ID: I20230911000185 |
| Provider Name | Melanie Neuner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083498646 PECOS PAC ID: 9830548312 Enrollment ID: I20231208002296 |
| Provider Name | Monica Ard Mcgee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588342570 PECOS PAC ID: 4385094986 Enrollment ID: I20231222000252 |
| Provider Name | Tonnette Hoffman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437601143 PECOS PAC ID: 4688958705 Enrollment ID: I20240126001707 |
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Santa Rosa Hma Physician Management Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4225 Woodbine Rd Ste G, Milton, FL 32571 Phone: 850-994-6575 Fax: 850-994-5643 | |
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