NORTHWEST FLORIDA MULTISPECIALTY PHYSICIANS LLC (NPI# 1790912269) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790912269 |
| Entity Type | Organization |
| Organization Name | NORTHWEST FLORIDA MULTISPECIALTY PHYSICIANS LLC |
| Practice Address |
1032 Mar Walt Dr Suite 250 Fort Walton Beach FL 32547-6661 |
| Mailing Address |
2000 Health Park Dr Brentwood TN 37027-4525 |
| Practice Telephone | 8508633463 |
| Mailing Telephone | 6153725426 |
| Mailing Fax Number | 8668314898 |
| Enumeration Date | 2009-06-11 |
| Last Update Date | 2017-11-10 |
| Authorized Official Name | JOHN MARK RODKEY (VICE PRESIDENT) |
| Authorized Official Telephone | 8505233816 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians |
| Street Address |
1032 MAR WALT DR SUITE 250 |
| City | FORT WALTON BEACH |
| State | FL |
| Zip Code | 32547-6661 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609872688 | John Robert Brent | Surgery | 1032 Mar Walt Dr, Ste 220, Fort Walton Beach, FL 32547-6645 | 2005-06-23 |
| 1275873275 | Timothy M Bradley,md Sc | Plastic Surgery | 1032 Mar Walt Dr, Suite 240, Fort Walton Beach, FL 32547-6661 | 2013-02-27 |
| 1205175635 | Barnett Facial Plastic & Reconstructive Surgery, Pa. | Otolaryngology | 1032 Mar Walt Dr, Suite 100, Fort Walton Beach, FL 32547-6661 | 2013-02-05 |
| 1679762611 | John R. Brent Md Pa | Specialist | 1032 Mar Walt Dr, Suite 220, Fort Walton Beach, FL 32547-6661 | 2007-10-16 |
| 1710172416 | Northwest Florida Womens Cancer Care LLC | Obstetrics & Gynecology | 1032 Mar Walt Dr, Suite 250, Fort Walton Beach, FL 32547-6661 | 2007-09-06 |
| 1497823942 | Inna Victorovna Martire | Physician Assistant | 1032 Mar Walt Dr, Fort Walton Beach, FL 32547-6645 | 2006-12-01 |
| 1912928896 | Ft Walton Beach Internal Medicine LLC | Internal Medicine | 1032 Mar Walt Dr, Suite 230, Fort Walton Beach, FL 32547-6645 | 2006-07-23 |
| 1295769263 | Beach Orthopaedic & Sports Medicine Clinic, Pa | Orthopaedic Surgery | 1032 Mar Walt Dr, Suite 210, Fort Walton Beach, FL 32547-6645 | 2006-07-10 |
| 1831122803 | Kenneth Robert Ellison | Physician Assistant | 1032 Mar Walt Dr, Suite 250, Fort Walton Beach, FL 32547-6661 | 2006-07-10 |
| 1265477574 | Emerald Coast Ear, Nose, Throat & Allergies, P.a. | Health Maintenance Organization | 1032 Mar Walt Dr, Suite 100, Fort Walton Beach, FL 32547-6645 | 2006-06-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255944955 | Theresa Ann Morvay | Behavior Technician | 419 Racetrack Rd Ne, Fort Walton Beach, FL 32547 | 2020-08-24 |
| 1588295422 | Emily Ann Glossop | Nurse Practitioner | 930 Mar Walt Drive C, Fort Walton Beach, FL 32547 | 2020-01-29 |
| 1225669443 | Elizabeth Rogers Nagengast | Physician Assistant | 930 Mar Walt Drive, Unit C, Fort Walton Beach, FL 32547 | 2020-01-27 |
| 1497254791 | Carmen Alston | Nurse Practitioner | 930 Mar Walt Dr C, Fort Walton Beach, FL 32547 | 2018-02-02 |
| 1871004960 | Center for Neuropsychological Services Cns | Clinical Neuropsychologist | 1817 Lewis Turner Blvd, Fort Walton Beach, FL 32547 | 2017-10-17 |
| 1194235648 | Robin Wray | Speech-Language Pathologist | 930 Mar Walt Dr D, Fort Walton Beach, FL 32547 | 2017-10-10 |
| 1285007989 | Dynamic Pain & Wellness Pllc | Pain Medicine | 930 Marwalt Drive, Suite B and C, Fort Walton Beach, FL 32547 | 2015-11-04 |
| 1013392810 | Terry Abbott | Social Worker | 648 Overbrook Dr, Fort Walton Beach, FL 32547 | 2015-07-22 |
| 1083024673 | Emily Lohr | Physical Therapy Assistant | 2000 Principle Ln, Ft. Walton Beach, FL 32547 | 2014-05-05 |
| 1831526102 | Laurie Ann Schweppe | Nurse Practitioner | 1005 Mar Walt Drivve, Snf Hospitalist Department, Fort Walton Beach, FL 32547 | 2013-10-02 |
| Find all providers in zip 32547 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073749644 | Noah Ridings Converse | Neurological Surgery | 1032 Mar Walt Dr Unit 250, Fort Walton Beach, FL 32547-6663 | 2009-06-09 |
| 1952487241 | Timothy R. Monroe | Neurological Surgery | 350g Racetrack Rd Nw, Fort Walton Beach, FL 32547-1699 | 2006-10-29 |
| 1174536551 | Thomas J. Manski, M.d., P.a. | Neurological Surgery | 350 Racetrack Rd Nw, Fort Walton Beach, FL 32547-1554 | 2006-08-15 |
| 1184235558 | Spine Institute On The Emerald Coast | Neurological Surgery | 350g Racetrack Rd Nw, Fort Walton Beach, FL 32547-1699 | 2020-08-11 |
| 1225078934 | Thomas Manski | Neurological Surgery | 350 Racetrack Rd Nw, Fort Walton Beach, FL 32547-1554 | 2006-06-08 |
| 1376528000 | Joseph E Levine | Neurological Surgery | 1106 Hospital Rd, Neurological Surgery Department, Fort Walton Beach, FL 32547-6742 | 2005-12-15 |
| 1447235577 | Robert P Feldman | Neurological Surgery | 1032 Mar Walt Dr, Suite 250, Fort Walton Beach, FL 32547-6661 | 2005-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063032514 | Jose Valerio Md Pllc | Neurological Surgery | 2741 Executive Park Dr Ste 2, Weston, FL 33331-3641 | 2020-04-24 |
| 1376172478 | Neuspine Ancillary LLC | Neurological Surgery | 510 Vonderburg Dr Ste 213, Brandon, FL 33511-5981 | 2020-04-02 |
| 1013542364 | Michelle Carnes | Neurological Surgery | 2575 Northbrooke Plaza Dr Unit 100, Naples, FL 34119-8105 | 2020-03-06 |
| 1962049163 | East Coast Neuro Spine Clinic, LLC | Neurological Surgery | 1601 S Apollo Blvd Ste C, Melbourne, FL 32901-4484 | 2019-12-06 |
| 1659913796 | Orlando Neurosurgical Solutions LLC | Neurological Surgery | 2706 Rew Cir # 205, Ocoee, FL 34761-4215 | 2019-10-10 |
| 1760047831 | North Broward Neurospinal Surgery Inc | Neurological Surgery | 1 W Sample Rd Ste 209, Pompano Beach, FL 33064-3547 | 2019-05-04 |
| 1932672912 | Volusia Neurosurgical Associates | Neurological Surgery | 311 N Clyde Morris Blvd Ste 440, Daytona Beach, FL 32114-2757 | 2019-01-02 |
| 1861961344 | Expert Neurosurgical Services LLC | Neurological Surgery | 600 Heritage Dr Ste 105, Jupiter, FL 33458-3098 | 2018-11-14 |
| 1902374630 | Guilherme Jose Agnoletto | Neurological Surgery | 800 Prudential Drive Weaver Tower 11th Floor, Jacksonville, FL 32207 | 2018-11-12 |
| 1114492493 | Lloyd Maliner, Md Pa | Neurological Surgery | 301 Nw 84th Ave Ste 206, Plantation, FL 33324-1807 | 2018-10-12 |
| Find all providers with the same taxonomy | ||||
| City | FORT WALTON BEACH |
| Zip Code | 32547 |
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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.