NORTH OKALOOSA PHYSICIANS GROUP – NPI #1558930313
General Practice

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Health Care Provider Taxonomy Code for General Practice

NORTH OKALOOSA PHYSICIANS GROUP is a provider located in CRESTVIEW, FL. NPPES has assigned the NPI number 1558930313 to NORTH OKALOOSA PHYSICIANS GROUP on June 24, 2021. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “NORTH OKALOOSA PHYSICIANS GROUP” is a dba name, the actual legal business name for this organization is NORTH OKALOOSA CLINIC CORP. This provider is also associated with 2 additional names listed below. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 208D00000X from the Health Care Provider Taxonomy code set, which is classified as General Practice. Bear in mind that having a taxonomy code selected doesn't replace any credentialing or validation process that may be required by law.

The NPI profile was previously updated about 2 years ago on May 14, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for NORTH OKALOOSA PHYSICIANS GROUP below.

NPI Profile for
NORTH OKALOOSA CLINIC CORP

NPI Number
1558930313
Enumeration Date

(about 5 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
NORTH OKALOOSA CLINIC CORP
Doing Business As (dba): NORTH OKALOOSA PHYSICIANS GROUP
Other name(s)
All associated names:
Doing Business As (dba)
North Okaloosa Clinic Corp
Doing Business As (dba)
North Okaloosa Physicians Group
Primary location
131 E REDSTONE AVE STE 105
CRESTVIEW, FL 32539-5355
Phone: (850) 398-8725 Fax: (850) 398-8727
Mailing address
PO BOX 689022
FRANKLIN, TN 37068-9022
Phone: (615) 465-7211 Fax: (615) 628-6877
Organization Subpart
No
Authorized Official
JENNIFER JACKSON
SR DIR PROV ENROLLMENT & ONBOARDING
Phone: (615) 465-3334
Updated
Certification Date
May 14, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for NORTH OKALOOSA PHYSICIANS GROUP

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
medicaidFL273693408
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
208D00000X
- General Practice (Primary)
363A00000X
- Physician Assistant
2080A0000X
- Pediatrics / Adolescent Medicine
208000000X
- Pediatrics
207R00000X
- Internal Medicine
207Q00000X
- Family Medicine

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.