White-wilson Medical Center Pa - Medicare Primary Care in Fort Walton Beach, FL

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White-wilson Medical Center Pa is a medicare enrolled primary clinic (Clinic/center) in Fort Walton Beach, Florida. The current practice location for White-wilson Medical Center Pa is 1005 Mar Walt Dr, Administration, Fort Walton Beach, Florida. For appointments, you can reach them via phone at (850) 863-8131. The mailing address for White-wilson Medical Center Pa is 1005 Mar Walt Dr, Administration, Fort Walton Beach, Florida and phone number is (850) 863-8131.

White-wilson Medical Center Pa is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1467437277. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (850) 863-8131.

Contact Information

White-wilson Medical Center Pa
1005 Mar Walt Dr
Administration
Fort Walton Beach
FL 32547-6707
(850) 863-8131
(850) 863-4152

Map and Direction


Primary Care Clinic Profile

Full NameWhite-wilson Medical Center Pa
SpecialityClinic/Center
Location1005 Mar Walt Dr, Fort Walton Beach, Florida
Authorized Official Name and PositionKathy A Leeper (MEDICAL STAFF COORDINATOR)
Authorized Official Contact8508638150
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
White-wilson Medical Center Pa
1005 Mar Walt Dr
Administration
Fort Walton Beach
FL 32547-6707

Ph: (850) 863-8131		White-wilson Medical Center Pa
1005 Mar Walt Dr
Administration
Fort Walton Beach
FL 32547-6707

Ph: (850) 863-8131

NPI Details:

NPI Number1467437277
Provider Enumeration Date12/14/2005
Last Update Date01/16/2025

Medicare PECOS Information:

Medicare PECOS PAC ID4082510607
Medicare Enrollment IDO20031212000140

Medical Identifiers

Medical identifiers for White-wilson Medical Center Pa such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1467437277NPI-NPPES
059722800MedicaidFL

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261Q00000XClinic/center (* (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. White-wilson Medical Center Pa acts as a billing entity for following providers:
Provider NameSara Ann Rushing
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1295793586
PECOS PAC ID: 8820981780
Enrollment ID: I20040204000771
Provider NameBeatriz Catral
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1851345037
PECOS PAC ID: 0749273811
Enrollment ID: I20040405001523
Provider NameDouglas Winston Rigby
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1265417166
PECOS PAC ID: 6800792433
Enrollment ID: I20040528001112
Provider NameAjay K Goyal
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1689786774
PECOS PAC ID: 2860442100
Enrollment ID: I20050126000704
Provider NameJohn Edwin Mills
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1437134301
PECOS PAC ID: 1052345212
Enrollment ID: I20050927000291
Provider NamePaul Tartarilla
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1285610899
PECOS PAC ID: 4183637317
Enrollment ID: I20060711000070
Provider NameRandall Louis Mckissack
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1487639621
PECOS PAC ID: 3476595364
Enrollment ID: I20061114000035
Provider NameFred Earhart Aubert
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1952307878
PECOS PAC ID: 1355240656
Enrollment ID: I20061120000184
Provider NameTimothy David Skinner
Provider TypePractitioner - Qualified Audiologist
Provider IdentifiersNPI Number: 1043433022
PECOS PAC ID: 7113027673
Enrollment ID: I20070712000547
Provider NameAbbas A Chamsuddin
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1578539557
PECOS PAC ID: 0446150262
Enrollment ID: I20070724000251
Provider NameJohn C Chaney
Provider TypePractitioner - Pulmonary Disease
Provider IdentifiersNPI Number: 1346270592
PECOS PAC ID: 8426149923
Enrollment ID: I20070814000012
Provider NameJohn Christofer Dali
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1023083177
PECOS PAC ID: 3870683816
Enrollment ID: I20071214000259
Provider NameChristopher Dale Abrasley
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1760505341
PECOS PAC ID: 0840364824
Enrollment ID: I20080808000680
Provider NameAndrew J Mcdonnell
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1912968025
PECOS PAC ID: 3779557590
Enrollment ID: I20090610000292
Provider NameChristopher Brian Cave
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1730169848
PECOS PAC ID: 2062550171
Enrollment ID: I20091111000366
Provider NameDavid William Burkland
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1467437616
PECOS PAC ID: 3072653864
Enrollment ID: I20091230000149
Provider NameKarl Walter Metz
Provider TypePractitioner - General Practice
Provider IdentifiersNPI Number: 1134104169
PECOS PAC ID: 1759461866
Enrollment ID: I20091230000221
Provider NameChristopher Michael Hansen
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1306821293
PECOS PAC ID: 4880735422
Enrollment ID: I20100105000514
Provider NameReed Leighton Harned
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1265417398
PECOS PAC ID: 6709927353
Enrollment ID: I20100105000608
Provider NameMelissa Josephine Fischer
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1942285036
PECOS PAC ID: 0749321727
Enrollment ID: I20100113000358
Provider NameTerry L Payne
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1053396002
PECOS PAC ID: 0446391429
Enrollment ID: I20100113000384
Provider NameGilberto Luis Vigo
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1790760502
PECOS PAC ID: 1153462130
Enrollment ID: I20100113000405
Provider NameAndrew Menhuang Yang
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1679558852
PECOS PAC ID: 0840331708
Enrollment ID: I20100114000231
Provider NameCharles Mark Riggenbach
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1346225240
PECOS PAC ID: 9234271198
Enrollment ID: I20100115000344
Provider NameVergil Kenneth Brown
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1871578955
PECOS PAC ID: 2062554686
Enrollment ID: I20100120000663
Provider NameVicente Arturo Mendez
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1740257773
PECOS PAC ID: 8325015670
Enrollment ID: I20100309000462
Provider NameVincent T Jones
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1285628743
PECOS PAC ID: 6507995065
Enrollment ID: I20100521000820
Provider NameKrishan Nagda
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1033182027
PECOS PAC ID: 7416855671
Enrollment ID: I20100629000409
Provider NamePamela Y Lee
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1467763326
PECOS PAC ID: 5092846162
Enrollment ID: I20100706000795
Provider NameRodney E Powell
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1821063959
PECOS PAC ID: 5395878292
Enrollment ID: I20100729000134
Provider NameAngel Nunez
Provider TypePractitioner - Pulmonary Disease
Provider IdentifiersNPI Number: 1366543456
PECOS PAC ID: 9739374901
Enrollment ID: I20101119000295
Provider NameClaire M Lakes
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1235421165
PECOS PAC ID: 2163600347
Enrollment ID: I20110617000581
Provider NameRichard Charles Reno
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1295849438
PECOS PAC ID: 4981877263
Enrollment ID: I20111102000095
Provider NameRichard D Freier
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1568625804
PECOS PAC ID: 9234304007
Enrollment ID: I20111206000166
Provider NameChinh Vien Van
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1124336839
PECOS PAC ID: 0042468548
Enrollment ID: I20120906000769
Provider NameKirk Francis Garcia-rios
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1033341821
PECOS PAC ID: 9335392166
Enrollment ID: I20130103000441
Provider NameYuan Wang
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1407016579
PECOS PAC ID: 2264506211
Enrollment ID: I20130307000179
Provider NameRobert Franklin Shelton
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1871578781
PECOS PAC ID: 6103906219
Enrollment ID: I20130701000362
Provider NameEvan Roy Meeks
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1376533869
PECOS PAC ID: 7618118779
Enrollment ID: I20130801000311
Provider NameKurt Christian Eppley
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1962601815
PECOS PAC ID: 5597927756
Enrollment ID: I20131023001033
Provider NameClarence Michael Hutto
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1245461508
PECOS PAC ID: 7012145907
Enrollment ID: I20140123000846
Provider NameDeborah Lynn Gilmore
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1104248251
PECOS PAC ID: 5890924831
Enrollment ID: I20140214001107
Provider NameLindsey A Mann-badyrka
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1457766214
PECOS PAC ID: 2163743386
Enrollment ID: I20150530000049
Provider NamePhilip Frank Jessen
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1871977173
PECOS PAC ID: 4587970355
Enrollment ID: I20150825004700
Provider NameMervin Manuel
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1215070396
PECOS PAC ID: 4789777939
Enrollment ID: I20151002001083
Provider NameAna May Magdalen Pascual Manuel
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1548498512
PECOS PAC ID: 0345497186
Enrollment ID: I20151019000525
Provider NameWilliam Elsworth Gross
Provider TypePractitioner - Otolaryngology
Provider IdentifiersNPI Number: 1114916756
PECOS PAC ID: 4284823386
Enrollment ID: I20151203001554
Provider NameCharles Bradley Arbogast
Provider TypePractitioner - Nephrology
Provider IdentifiersNPI Number: 1740269448
PECOS PAC ID: 3971742214
Enrollment ID: I20151222002423
Provider NameWalter Rustmann
Provider TypePractitioner - Critical Care (intensivists)
Provider IdentifiersNPI Number: 1235116054
PECOS PAC ID: 0042251506
Enrollment ID: I20160209002010
Provider NameLuke Simon Olivera Yuhico
Provider TypePractitioner - Critical Care (intensivists)
Provider IdentifiersNPI Number: 1740414465
PECOS PAC ID: 6608027487
Enrollment ID: I20160215001353
Provider NameKristopher Stewart Oldham
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1619357787
PECOS PAC ID: 7315250248
Enrollment ID: I20161119000257
Provider NameMelissa Squires
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1760670970
PECOS PAC ID: 4183794605
Enrollment ID: I20170125001282
Provider NameRonald Lee Barnes
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1962469981
PECOS PAC ID: 2860473022
Enrollment ID: I20170522002928
Provider NameKatrina Pendleton Borner
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1467988220
PECOS PAC ID: 7719257260
Enrollment ID: I20170717002549
Provider NameShawn Gerard Hughes
Provider TypePractitioner - Pain Management
Provider IdentifiersNPI Number: 1033473772
PECOS PAC ID: 5698904449
Enrollment ID: I20170801000887
Provider NameConnie Marie Slaughter
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1104141928
PECOS PAC ID: 6709069636
Enrollment ID: I20170803001782
Provider NameBrittany Nicole Grimes
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1013434570
PECOS PAC ID: 0143587048
Enrollment ID: I20171201000514
Provider NameKatherine Lois Stuart
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1679060198
PECOS PAC ID: 1254696859
Enrollment ID: I20180601000887
Provider NamePatricia Ann Burnett
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1295231421
PECOS PAC ID: 0648535922
Enrollment ID: I20180607003142
Provider NamePoorita Singh
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1336633718
PECOS PAC ID: 8426309873
Enrollment ID: I20180924001867
Provider NameLloyd D Wagner
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1124161872
PECOS PAC ID: 3870517923
Enrollment ID: I20181029001815
Provider NameJacob Aaron Urda
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1427445477
PECOS PAC ID: 6608111869
Enrollment ID: I20181218000088
Provider NameBrittany Anne Mosley
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1811452709
PECOS PAC ID: 5092054858
Enrollment ID: I20190222001650
Provider NameTrena Rios
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1326549809
PECOS PAC ID: 2860731718
Enrollment ID: I20190312000172
Provider NameBrittany Marie Arbacheski Fais
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1326607276
PECOS PAC ID: 9234467614
Enrollment ID: I20190822003017
Provider NameMitchell Drew Martineau
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1417994815
PECOS PAC ID: 8123047065
Enrollment ID: I20191121001545
Provider NameFabian Alexandro Consbruck
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1740764158
PECOS PAC ID: 5193158095
Enrollment ID: I20191206002230
Provider NameMarlon K Tudlong
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1548801897
PECOS PAC ID: 0547694358
Enrollment ID: I20200103001631
Provider NameJulian Vladimirovich Tokarev
Provider TypePractitioner - Ophthalmology
Provider IdentifiersNPI Number: 1629463732
PECOS PAC ID: 3870829807
Enrollment ID: I20200716001600
Provider NameTyler Hamilton
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1265856819
PECOS PAC ID: 4183994882
Enrollment ID: I20200811000345
Provider NameEric Daniel Hinojosa
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1629686878
PECOS PAC ID: 9830516301
Enrollment ID: I20200828001220
Provider NameHelena Sylvia Richard
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1538778378
PECOS PAC ID: 5597182972
Enrollment ID: I20200831002116
Provider NameJulie Clausen Powell
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1053605857
PECOS PAC ID: 4981882313
Enrollment ID: I20201103002285
Provider NameShawn Lee
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1043285091
PECOS PAC ID: 9436251444
Enrollment ID: I20201211002722
Provider NameMadeline Maria-fernanda Strittmatter
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1962938233
PECOS PAC ID: 1850703950
Enrollment ID: I20201215000038
Provider NameLaura Ann Bruck-hillas
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1093301897
PECOS PAC ID: 6709299852
Enrollment ID: I20210108001195
Provider NameEmily Bertsch
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1356869267
PECOS PAC ID: 6002180809
Enrollment ID: I20210121000665
Provider NameAmjad A Safvi
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1093707457
PECOS PAC ID: 7012809650
Enrollment ID: I20210311002793
Provider NameKaren Diane Hoffman
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1154396018
PECOS PAC ID: 7719942226
Enrollment ID: I20210325000307
Provider NameShana Denise Haywood
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1306428768
PECOS PAC ID: 6800205097
Enrollment ID: I20210428002451
Provider NameBryan Shane Robinson
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1841403441
PECOS PAC ID: 3274707856
Enrollment ID: I20210511002081
Provider NameMelanie V Parm
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1710259981
PECOS PAC ID: 6608182399
Enrollment ID: I20210520001418
Provider NameKelley Michelle Coone
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1013586130
PECOS PAC ID: 5193128460
Enrollment ID: I20210723001377
Provider NameDavid Erickson
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1942390232
PECOS PAC ID: 3173856184
Enrollment ID: I20210824001660
Provider NameJason B Crowder
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1114988086
PECOS PAC ID: 6800960790
Enrollment ID: I20210907000924
Provider NameEudeum Lee Kim
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1043980006
PECOS PAC ID: 9133526452
Enrollment ID: I20210928003827
Provider NameAmanda Davis
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1205435518
PECOS PAC ID: 4183022205
Enrollment ID: I20211004002727
Provider NameMargaret Ann Avery
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1306422191
PECOS PAC ID: 6800285313
Enrollment ID: I20211122001492
Provider NameCynthia Lynn Cuson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1346676277
PECOS PAC ID: 6709013907
Enrollment ID: I20211124001520
Provider NameMary Jean Middleton
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1972009629
PECOS PAC ID: 6406108737
Enrollment ID: I20211221001539
Provider NameDale Volquartsen
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1841250594
PECOS PAC ID: 3173701174
Enrollment ID: I20220106002634
Provider NameTamara Louise Mckelvy
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1699731687
PECOS PAC ID: 7810903473
Enrollment ID: I20220420002879
Provider NameMelissa A Chrites
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1801216635
PECOS PAC ID: 4688996895
Enrollment ID: I20220502000464
Provider NameMegan Walsh-aleem
Provider TypePractitioner - Registered Dietitian Or Nutrition Professional
Provider IdentifiersNPI Number: 1891103644
PECOS PAC ID: 1557757952
Enrollment ID: I20220527001818
Provider NameNikkole Nunez Town
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1164163325
PECOS PAC ID: 7214317650
Enrollment ID: I20220701002040
Provider NameGlenn Raymond Fernandes
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1841356441
PECOS PAC ID: 5597086827
Enrollment ID: I20220718003883
Provider NameAnimesh Chandulal Shah
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1265457485
PECOS PAC ID: 7810934346
Enrollment ID: I20220816001494
Provider NamePeter Hsu Shih
Provider TypePractitioner - Pulmonary Disease
Provider IdentifiersNPI Number: 1023006665
PECOS PAC ID: 4880678986
Enrollment ID: I20220912000040
Provider NameKyana Anthony
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1043456213
PECOS PAC ID: 6709270283
Enrollment ID: I20221110003038
Provider NameKimberly Litwiller
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1679056527
PECOS PAC ID: 9638415771
Enrollment ID: I20230125002445
Provider NameAnnmarie Carucci Dowden
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1194426601
PECOS PAC ID: 2668846908
Enrollment ID: I20230328001184
Provider NameAshley Theresa Cusson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1346933892
PECOS PAC ID: 5496113896
Enrollment ID: I20230616000813
Provider NameStephanie Ann Wilson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1386060929
PECOS PAC ID: 5395969661
Enrollment ID: I20230828002722
Provider NameSteven John Hart
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1598982191
PECOS PAC ID: 5193867968
Enrollment ID: I20230918001123
Provider NameRobert Mclean
Provider TypePractitioner - Otolaryngology
Provider IdentifiersNPI Number: 1558364398
PECOS PAC ID: 2961399092
Enrollment ID: I20240116003932
Provider NameAmanda Finley
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1174817035
PECOS PAC ID: 3274760590
Enrollment ID: I20240124001980
Provider NameMaximina A Boutselis
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1013946094
PECOS PAC ID: 6002002151
Enrollment ID: I20240209003843
Provider NameMicheal Shane Blocker
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1487134052
PECOS PAC ID: 5698026862
Enrollment ID: I20240228001459
Provider NameKimberly Dawn Marshall
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1538923297
PECOS PAC ID: 9335585728
Enrollment ID: I20240307002259
Provider NameHannah Lee Waters
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1740898063
PECOS PAC ID: 8123464484
Enrollment ID: I20240308000698
Provider NameCraig Henry
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1215789714
PECOS PAC ID: 9234579574
Enrollment ID: I20240502003502
Provider NameBrianna Leigh Rider
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1982372413
PECOS PAC ID: 0143662312
Enrollment ID: I20240521000491
Provider NameTaylor Shannon Boone
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1871344218
PECOS PAC ID: 6002258886
Enrollment ID: I20240524000587
Provider NameDeneb Wright
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1942068051
PECOS PAC ID: 0648712513
Enrollment ID: I20240606001915
Provider NameJudy Lynn Hoffman
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1730162470
PECOS PAC ID: 1759323496
Enrollment ID: I20240725000125
Provider NameMargaret Lynn Laforge
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1558181693
PECOS PAC ID: 8921531013
Enrollment ID: I20241028003320
Provider NameDawn Bopes
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1962114215
PECOS PAC ID: 3870965981
Enrollment ID: I20250124000048
Provider NameDustin Lee Yontz
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1326275694
PECOS PAC ID: 1759540958
Enrollment ID: I20250312002134
Provider NameLisa Mabry Smith
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1912298498
PECOS PAC ID: 6406092295
Enrollment ID: I20250322000046
Provider NameMark Burnette Wall
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1053447268
PECOS PAC ID: 5193883569
Enrollment ID: I20250402003535

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Medicare: Medicare Enrolled
Practice Location: 322 Racetrack Rd Ne, Fort Walton Beach, FL 32547
Phone: 850-863-3000    Fax: 850-374-3200
White-wilson Medical Center, P.a.
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 1005 Mar Walt Dr, Fp Department, Fort Walton Beach, FL 32547
Phone: 850-863-6600    Fax: 850-862-0977
Bridgeway Center, Inc
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 137 Hospital Dr Ne, Fort Walton Beach, FL 32548
Phone: 850-226-8857    Fax: 850-226-8859

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.