PAIN CLINIC OF NORTHWEST FL, INC (NPI# 1225244395) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225244395 |
| Entity Type | Organization |
| Organization Name | PAIN CLINIC OF NORTHWEST FL, INC |
| Practice Address |
4284 Kelson Ave Marianna FL 32446 |
| Mailing Address |
2250 Harrison Ave Panama City FL 32405 |
| Practice Telephone | 8507842477 |
| Practice Fax Number | 8507846848 |
| Mailing Telephone | 8507842477 |
| Mailing Fax Number | 8507846848 |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2012-01-03 |
| Authorized Official Name | DR. ROBERT J JOSEPH (PRESIDENT) |
| Authorized Official Telephone | 8507842477 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | DMERC PTAN | 3857260001 | 01 |
| FL | 2680076 01 | 05 | |
| FL | RRB PTAN | CM7126 | 01 |
| Street Address |
4284 KELSON AVE |
| City | MARIANNA |
| State | FL |
| Zip Code | 32446 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699720367 | Mark R Akerson | Family Medicine | 4284 Kelson Ave, Marianna, FL 32446-2948 | 2006-05-23 |
| 1487108171 | Kristin Kent Owens | Nurse Practitioner | 4284 Kelson Ave, Marianna, FL 32446-2948 | 2016-08-10 |
| 1851641864 | Donna Fowler | Nurse Practitioner | 4284 Kelson Ave, Marianna, FL 32446-2948 | 2012-09-17 |
| 1043535396 | Stephen Tracy Mears | Nurse Practitioner | 4284 Kelson Ave, Marianna, FL 32446-2948 | 2010-03-30 |
| 1598930679 | Panhandle Family Care Associates Inc | Family Medicine | 4284 Kelson Ave, Marianna, FL 32446-2948 | 2008-04-29 |
| 1538212394 | Brenda J Nesmith | Nurse Practitioner | 4284 Kelson Ave, Marianna, FL 32446-2948 | 2007-01-18 |
| 1245389303 | Houston County Healthcare Authority | Family Medicine | 4284 Kelson Ave, Marianna, FL 32446-2948 | 2007-01-09 |
| 1497794796 | John A. Spence | Family Medicine | 4284 Kelson Ave, Marianna, FL 32446-2948 | 2006-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962054817 | Covenant Home Health Care, LLC | Home Health | 4540 Lafayette Street, Ste. G, Marianna, FL 32446 | 2019-07-11 |
| 1063902930 | Syntha Alvarez | Assistant Behavior Analyst | 3217 Highway 71, Marianna, FL 32446 | 2018-05-15 |
| 1922528926 | Charlotte Allen | Respite Care | 4326 Deering Street, Marianna, FL 32446 | 2017-06-21 |
| 1003352097 | Jonathan Lee | Physical Therapist | 4387 Kelson Ave Apt A, Marianna, FL 32446 | 2017-01-13 |
| 1386003192 | Harold B Parker | Nurse Practitioner | Sunland Center 3700 Williams Drive, Marianna, FL 32446 | 2016-02-22 |
| 1912372756 | John Tyler Ellerbee | Nurse Practitioner | 4215 E Kelson Ave, Marianna, FL 32446 | 2015-12-04 |
| 1902206790 | Jason Williams | Spec/Tech, Cardiovascular | 3625 Fci Road, Marianna, FL 32446 | 2014-08-28 |
| 1336558238 | Rocky Mountain Holdings, LLC | Ambulance | 3689 Industrial Park Dr, Marianna, FL 32446 | 2014-08-05 |
| 1831430826 | Jantzen Wayne Whitehead | Counselor | 2860 Highway 71 N, Suite A, Marianna, FL 32446 | 2013-03-15 |
| 1336498047 | Sharon Lynn Miller | Counselor | 2933 Madison Street, Marianna, FL 32446 | 2012-09-10 |
| Find all providers in zip 32446 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790732881 | Er Physician Group At Jackson Hospital | Specialist | 4298 5th Ave, Marianna, FL 32446-2173 | 2006-05-27 |
| 1396735858 | David Arthur Flick | Specialist | 4306 3rd Ave Ste B, Marianna, FL 32446-2121 | 2005-10-26 |
| 1790146140 | Marianna Imaging, LLC | Specialist | 4250 Hospital Dr, Marianna, FL 32446-1917 | 2016-03-13 |
| 1558695668 | Steven Paul Surgnier | Specialist | 4230 Hospital Dr, Suite 210, Marianna, FL 32446-1934 | 2009-09-22 |
| 1164636700 | Lisa Kathryn Debrauwere | Specialist | 4230 Lafayette St Ste C, Massage Room, Marianna, FL 32446-8231 | 2007-05-10 |
| 1881815520 | Jackson County Hospital District | Specialist | 3051 6th St, Marianna, FL 32446-1933 | 2007-05-01 |
| 1962532655 | Marianna Ob Gyn Associates P A | Specialist | 4230 Hospital Dr, Suite 209, Marianna, FL 32446-1955 | 2007-03-06 |
| 1710089479 | Wensi Natasha West | Specialist | 4440 Lafayette St Ste K, Marianna, FL 32446-3411 | 2006-09-02 |
| 1578592499 | Joseph T Sherrel | Specialist | 4316 5th Ave, Marianna, FL 32446-2182 | 2006-07-02 |
| 1407895584 | Er Physician Group At Jackson Hospital | Specialist | 4298 5th Ave, Marianna, FL 32446-2173 | 2006-06-05 |
| Find all providers in MARIANNA | ||||
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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.