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MAGNOLIA MEDICAL CLINIC P.A.
NPI 1053110619
Family Medicine in Destin, FL

Active since March 07, 2025CLIA 10D0271510 · Accreditation
4012 COMMONS DR W, DESTIN, FL 32541(850) 243-7681(850) 243-0471 Get Directions Write a Review

NPPES record last updated: March 7, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Magnolia Medical Clinic P.a. NPPES

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

MAGNOLIA MEDICAL CLINIC P.A. (NPI 1053110619) is a healthcare organization registered as a family medicine in Destin, Florida and active in the NPI registry since March 2025. The organization holds an CLIA Accreditation certificate valid through July 11, 2027 and lists Crystal Weatherington, Practice Administrator, as its authorized official.

NPPES Registry Identity

NPI1053110619
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMAGNOLIA MEDICAL CLINIC P.A.
Location Address4012 COMMONS DR WDestin, FL 32541-8422
Mailing Address319 Green Acres Rd Ste 101Fort Walton Beach, FL 32547-1170
Phone(850) 243-7681
Fax(850) 243-0471
Organization SubpartNo
Authorized OfficialCrystal WeatheringtonPractice Administrator · (850) 243-0520
Enumeration DateMarch 7, 2025
NPPES CertifiedMarch 7, 2025
✔ NPI 1053110619 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
4012 COMMONS DR W, Destin, FL 32541
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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).Insurance ›

CLIA Laboratory Certificates CMS CLIA

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 Accreditation 10D0271510

Magnolia Medical Clinic · Fort Walton Beach, FL
Active · expires Jul 11, 2027
CLIA Number10D0271510
Laboratory TypePhysician Office
Certificate Effective DateJuly 12, 2025
Certificate Expiration DateJuly 11, 2027
Laboratory DirectorDr. Asenath Day
Laboratory Phone(850) 243-7681
Laboratory LocationMagnolia Medical Clinic319 Green Acres Rd Ste 101, Fort Walton Beach, FL 32547
CLIA data matches this NPI record on: Address Name Phone
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 5

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

DR. KEVIN W WELLS OD
Optometrist
4012 COMMONS DR W, STE 110
DESTIN, FL 32541
Okaloosa County (580) 223-5300
GULF COAST GYNECOLOGY, INC.
Obstetrics & Gynecology (Gynecology)
4012 COMMONS DR W, SUITE 100
DESTIN, FL 32541
Okaloosa County (850) 837-0576
COASTAL UROLOGY P A
Urology
4012 COMMONS DR W, SUITE 100
DESTIN, FL 32541
Okaloosa County (850) 837-0442
TED CHUNG M.D.
Urology
4012 COMMONS DR W, SUITE 100
DESTIN, FL 32541
Okaloosa County (850) 837-0442
ANN THUY NGUYEN M.D.
Obstetrics & Gynecology (Gynecology)
4012 COMMONS DR W, SUITE 100
DESTIN, FL 32541
Okaloosa County (850) 837-0576

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 Magnolia Medical Clinic P.A.'s NPI number?

The NPI number for Magnolia Medical Clinic P.A. is 1053110619. It was assigned to this organization in the NPPES registry on March 7, 2025.

Where is Magnolia Medical Clinic P.A. located?

Magnolia Medical Clinic P.A. is located at 4012 Commons Dr W, Destin, FL 32541. The listed phone number is (850) 243-7681.

What is Magnolia Medical Clinic P.A.'s specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Magnolia Medical Clinic P.A. hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 10D0271510) is associated with this NPI, valid through July 11, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Magnolia Medical Clinic P.A. accept?

Health plans from Florida Blue (BlueCross BlueShield FL) list Magnolia Medical Clinic P.A. 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 Magnolia Medical Clinic P.A. was last updated on March 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.