ESCAMBIA COMMUNITY CLINICS INC (NPI# 1073842456) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073842456 |
| Entity Type | Organization |
| Organization Name | ESCAMBIA COMMUNITY CLINICS INC |
| Other Organization Name | 12TH AVENUE PEDIATRICS |
| Practice Address |
2510 N 12th Ave Pensacola FL 32503 |
| Mailing Address |
2315 W Jackson St Pensacola FL 32505-7552 |
| Practice Telephone | 8504710508 |
| Practice Fax Number | 8504710510 |
| Mailing Telephone | 8504364630 |
| Mailing Fax Number | 8504362095 |
| Enumeration Date | 2009-12-15 |
| Last Update Date | 2018-11-30 |
| Authorized Official Name | CHANDRA SMILEY (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 8504364630 |
| Authorized Official Credential | EXECUTIVE DIRECT |
| Is Organization Subpart | Y |
| Parent Organization Name | ESCAMBIA COMMUNITY CLINICS INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 692990705 | 05 |
| Other Name | Type Code |
|---|---|
| 12th Avenue Pediatrics | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952822173 | Escambia Community Clinics Inc | Clinic/Center | 6021 Industrial Blvd, Century, FL 32535 | 2017-06-28 |
| 1932568029 | Escambia Community Clinics Inc | Clinic/Center | 501 Church St, Century, FL 32535-2914 | 2016-02-17 |
| 1225469398 | Escambia Community Clinics Inc | Clinic/Center | 380 W Herman St, Pensacola, FL 32505-5249 | 2013-11-27 |
| 1790268159 | Escambia Community Clinics Inc | Clinic/Center | 5375 N 9th Ave, Pensacola, FL 32504-8725 | 2018-09-12 |
| 1033601794 | Escambia Community Clinics Inc | Clinic/Center | 4435 Highway 90, Pace, FL 32571 | 2018-05-30 |
| 1811344682 | Escambia Community Clinics Inc | Clinic/Center | 470 S Highway 29 Ste 2, Cantonment, FL 32533 | 2016-05-20 |
| 1497114953 | Escambia Community Clinics Inc | Clinic/Center | 2701 N Q St, Pensacola, FL 32505-5615 | 2016-02-12 |
| 1447615455 | Escambia Community Clinics Inc | Clinic/Center | 5855 Creek Station Dr, Pensacola, FL 32504-8626 | 2015-12-17 |
| 1497020549 | Escambia Community Clinics Inc | Clinic/Center | 14 W Jordan St, Suite A, Pensacola, FL 32501 | 2012-03-21 |
| 1215168992 | Escambia Community Clinics Inc | Clinic/Center | 748 N Highway 29, Cantonment, FL 32533 | 2009-07-29 |
| Street Address |
2510 N 12TH AVE |
| City | PENSACOLA |
| State | FL |
| Zip Code | 32503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902895394 | Debra Lynn Hemphill | Nurse Practitioner | 2510 N 12th Ave, Pensacola, FL 32503-4604 | 2005-10-18 |
| 1104183813 | Pamela Carr | Social Worker | 2510 N 12th Ave, Pensacola, FL 32503-4604 | 2012-04-19 |
| 1861666810 | Edith Maria Nieves Lopez | Pediatrics | 2510 N 12th Ave, Pensacola, FL 32503-4604 | 2008-04-21 |
| 1609885441 | Lisa D. Tucker, M.d., P.a. | Obstetrics & Gynecology | 2510 N 12th Ave, Pensacola, FL 32503-4604 | 2006-08-07 |
| 1740208149 | Amanda Lane Mcbride | Nurse Practitioner | 2510 N 12th Ave, Pensacola, FL 32503-4604 | 2006-07-17 |
| 1447234398 | Quetheline M Helvetius-lanza | Specialist | 2510 N 12th Ave, Pensacola, FL 32503-4604 | 2005-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134727472 | Lauren Barrett Evans | Nurse Practitioner | 4700 Bayou Boulevard, Suite 6, Pensacola, FL 32503 | 2020-10-09 |
| 1528666864 | Kelsey Christine Kvartek | Nurse Practitioner | 4700 Bayou Blvd., Suite 6, Pensacola, FL 32503 | 2020-10-09 |
| 1730790551 | Sacred Heart Hospital of Pensacola | Podiatrist | 1890 Summit Blvd, Pensacola, FL 32503 | 2020-08-14 |
| 1891312815 | Sacred Heart Asc, LLC | Clinic/Center | 1890 Summit Boulevard, Suite 210, Pensacola, FL 32503 | 2020-06-26 |
| 1275011744 | Teresa T Jansen | Registered Nurse | 5051 Carpenters Creek Dr, Pensacola, FL 32503 | 2018-08-06 |
| 1639662729 | Florida Physical Therapy Services of Pensacola, LLC | Occupational Therapist | 428 Airport Blvd, Pensacola, FL 32503 | 2018-06-13 |
| 1922595123 | Touch of Love Home Health Care LLC | Home Health | 139 E Burgess Rd Ste B, Pensacola, FL 32503 | 2018-04-13 |
| 1770012106 | Amber Mcclellan | Occupational Therapist | 4551 North Davis Highway, Suite C, Pensacola, FL 32503 | 2017-06-08 |
| 1780123885 | Corinne Georgette-marie Carlson | Registered Nurse | 6809 White Oak Drive, Pensacola, FL 32503 | 2017-02-22 |
| 1538615232 | Kristin E Patton | Dietitian, Registered | 4501 North Davis Hwy, Suite C, Pensacola, FL 32503 | 2016-09-01 |
| Find all providers in zip 32503 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225469398 | Escambia Community Clinics Inc | Clinic/Center | 380 W Herman St, Pensacola, FL 32505-5249 | 2013-11-27 |
| 1790268159 | Escambia Community Clinics Inc | Clinic/Center | 5375 N 9th Ave, Pensacola, FL 32504-8725 | 2018-09-12 |
| 1497114953 | Escambia Community Clinics Inc | Clinic/Center | 2701 N Q St, Pensacola, FL 32505-5615 | 2016-02-12 |
| 1447615455 | Escambia Community Clinics Inc | Clinic/Center | 5855 Creek Station Dr, Pensacola, FL 32504-8626 | 2015-12-17 |
| 1770911505 | Escambia Community Clinics, Inc | Clinic/Center | 1295 W Fairfield Dr, Pensacola, FL 32501-1107 | 2013-10-14 |
| 1275872780 | Escambia Community Clinics, Inc | Clinic/Center | 5868 Creek Station Dr Bldg A, Pensacola, FL 32504-8627 | 2013-02-04 |
| 1497020549 | Escambia Community Clinics Inc | Clinic/Center | 14 W Jordan St, Suite A, Pensacola, FL 32501 | 2012-03-21 |
| 1265720957 | Escambia Community Clinic Inc-lanza Pediatrics | Clinic/Center | 2200 N Palafox St, Pensacola, FL 32501-1723 | 2011-07-14 |
| 1366758088 | Escambia Community Clinics, Inc | Clinic/Center | 1201 W Hernandez St, Building E, Pensacola, FL 32501-1815 | 2010-08-19 |
| 1841487634 | Escambia Community Clinics Inc | Clinic/Center | 2315 W Jackson St, Pensacola, FL 32505-7552 | 2007-09-26 |
| Find all providers in PENSACOLA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.