LAWRENCE SCOTT ENNIS MD
NPI 1023199312
Specialist in Destin, FL

Q: What is Lawrence Ennis's NPI number?

The NPI number for Lawrence Ennis is 1023199312. It was assigned to this individual provider in the NPPES registry on October 17, 2006.

Q: What is Lawrence Ennis's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Q: Is Lawrence Ennis enrolled in Medicare?

No. Lawrence Ennis has opted out of Medicare through October 1, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Lawrence Ennis was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 17, 2006Opted out of Medicare · through Oct 1, 2026

4485 FURLING LN, DESTIN, FL 32541(850) 654-1194(850) 654-3380 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Lawrence Scott Ennis Md NPPES

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

LAWRENCE SCOTT ENNIS MD (NPI 1023199312) is an individual specialist in Destin, Florida, licensed in Florida (ME87360) and active in the NPI registry since October 2006. He has opted out of Medicare through October 1, 2026 and remains eligible to order and refer.

NPPES Registry Identity

NPI1023199312

Entity TypeIndividualMale

Primary Taxonomy174400000X

Provider Legal NameLAWRENCE SCOTT ENNISCredential: MD

Location Address4485 FURLING LNDestin, FL 32541-5331

Mailing Address4485 Furling LnDestin, FL 32541-5331 · (850) 654-1194 · Fax (850) 654-3380

Phone(850) 654-1194

Fax(850) 654-3380

Sole ProprietorNo

Enumeration DateOctober 17, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1023199312 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

License✔ Licensed in FL · ME87360

Definition

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.

4485 FURLING LN, Destin, FL 32541

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Other Identifiers 1

Medicare UPING81761FL

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Lawrence Scott Ennis Md has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 1, 2016 through October 1, 2026.

Opt-Out Effective DateOctober 1, 2016

Opt-Out In Effect ThroughOctober 1, 2026Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 8

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

WILLIAM EDELMAN PA

Physician Assistant