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PENSACOLA PEDIATRICS PA
NPI 1013680651
Pediatrics in Gulf Breeze, FL

Active since July 29, 2021CLIA Certified · 2 labs
1368 COUNTRY CLUB RD, GULF BREEZE, FL 32563(850) 934-9876(850) 916-0736 Get Directions Write a Review

NPPES record last updated: July 29, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Pensacola Pediatrics Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PENSACOLA PEDIATRICS PA (NPI 1013680651) is a healthcare organization registered as a pediatrics in Gulf Breeze, Florida and active in the NPI registry since July 2021. The organization holds 2 active CLIA laboratory certificates and lists Peter Heckathorn, Administrator, as its authorized official.

NPPES Registry Identity

NPI1013680651
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NamePENSACOLA PEDIATRICS PA
Location Address1368 COUNTRY CLUB RDGulf Breeze, FL 32563-3471
Mailing Address4951 Grande DrPensacola, FL 32504-8965 · (850) 473-0100 · Fax (850) 473-0500
Phone(850) 934-9876
Fax(850) 916-0736
Organization SubpartNo
Authorized OfficialPeter HeckathornAdministrator · (850) 473-0100
Enumeration DateJuly 29, 2021
NPPES CertifiedJuly 29, 2021
✔ NPI 1013680651 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

1368 COUNTRY CLUB RD, Gulf Breeze, FL 32563
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Other Identifiers 1

Medicaid063018701FL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 10D0271087

Pensacola Pediatrics PA · Pensacola, FL
Active · expires Oct 20, 2026
CLIA Number10D0271087
Laboratory TypePhysician Office
Certificate Effective DateOctober 21, 2024
Certificate Expiration DateOctober 20, 2026
Laboratory DirectorJessica C. Ewert
Laboratory Phone(850) 473-0100
Laboratory LocationPensacola Pediatrics PA4951 Grande Dr, Pensacola, FL 32504
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Waiver 10D2308163

Pensacola Pediatrics PA · Pensacola, FL
Active · expires Jul 22, 2028
CLIA Number10D2308163
Laboratory TypePhysician Office
Certificate Effective DateJuly 23, 2026
Certificate Expiration DateJuly 22, 2028
Laboratory DirectorPamela M. Grier-Hall
Laboratory Phone(850) 471-5060
Laboratory LocationPensacola Pediatrics PA5868 Creek Station Drive Airport Location, Pensacola, FL 32504
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. RANDALL E REESE MD
Pediatrics
1368 COUNTRY CLUB RD
GULF BREEZE, FL 32563
Santa Rosa County (850) 934-9876
MRS. PAMELA M KLEIN MD
Pediatrics
1368 COUNTRY CLUB RD
GULF BREEZE, FL 32563
Santa Rosa County (850) 934-9876
MRS. CYNTHIA R REEVES ARNP
Nurse Practitioner (Pediatrics)
1368 COUNTRY CLUB RD
GULF BREEZE, FL 32563
Santa Rosa County (850) 934-9876

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pensacola Pediatrics PA's NPI number?

The NPI number for Pensacola Pediatrics PA is 1013680651. It was assigned to this organization in the NPPES registry on July 29, 2021.

Where is Pensacola Pediatrics PA located?

Pensacola Pediatrics PA is located at 1368 Country Club Rd, Gulf Breeze, FL 32563. The listed phone number is (850) 934-9876.

What is Pensacola Pediatrics PA's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Pensacola Pediatrics PA hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Pensacola Pediatrics PA accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Pensacola Pediatrics PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Pensacola Pediatrics PA was last updated on July 29, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.