1. Home
  2. Directory
  3. Florida
  4. Defuniak Springs
  5. Clinic Center
  6. NPI Profile

WHITE-WILSON MEDICAL CENTER DFK
NPI 1063267128
Clinic/Center - Rural Health in Defuniak Springs, FL

Active since April 22, 2024CLIA Certified · 4 labs
1045 US HIGHWAY 331 S, DEFUNIAK SPRINGS, FL 32435(850) 892-3366(833) 451-2226 Get Directions Write a Review

NPPES record last updated: August 1, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 1, 2024, Apr 22, 2024 (2 updates tracked since 2024).

About White-wilson Medical Center Dfk NPPES

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

WHITE-WILSON MEDICAL CENTER DFK (NPI 1063267128) is a healthcare organization registered as a rural health in Defuniak Springs, Florida and active in the NPI registry since April 2024. The organization holds 4 active CLIA laboratory certificates, maintains 3 additional practice locations, and lists Kenneth Persaud, Ceo, as its authorized official.

NPPES Registry Identity

NPI1063267128
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameWHITE-WILSON MEDICAL CENTER, P.A.
Location Address1045 US HIGHWAY 331 SDefuniak Springs, FL 32435-3379
Mailing Address1005 Mar Walt DrFort Walton Beach, FL 32547-6707 · (850) 863-8299 · Fax (850) 863-4152
Phone(850) 892-3366
Fax(833) 451-2226
Organization SubpartYes
Authorized OfficialKenneth PersaudCeo · (850) 863-8150
Enumeration DateApril 22, 2024
Last NPPES UpdateAugust 1, 20242 updates tracked since enumeration
NPPES CertifiedAugust 1, 2024
✔ NPI 1063267128 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
1045 US HIGHWAY 331 S, Defuniak Springs, FL 32435
Open in Google Maps ↗

Other Names 1

Other NameWhite-wilson Medical Center Dfk

Secondary Practice Locations 3

Location 1130 E Redstone AveCrestview, FL 32539-5348 · Phone (850) 398-8725 · Fax (888) 987-3138
Location 2127 E Redstone AveCrestview, FL 32539-5358 · Phone (850) 398-8725 · Fax (833) 305-0362
Location 31332 N Ferdon BlvdCrestview, FL 32536-1749 · Phone (850) 634-6193

CLIA Laboratory Certificates CMS CLIA 4

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 Waiver 10D2175862

White-Wilson Medical Center PA · Crestview, FL
Active · expires Dec 2, 2027
CLIA Number10D2175862
Laboratory TypeCommunity Clinic
Certificate Effective DateDecember 3, 2025
Certificate Expiration DateDecember 2, 2027
Laboratory DirectorVincente A. Mendez
Laboratory Phone(850) 863-8284
Laboratory LocationWhite-Wilson Medical Center PA1332 N Ferdon Blvd, Crestview, FL 32536
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D2235839

White-Wilson Medical Center, PA · Crestview, FL
Active · expires Sep 12, 2027
CLIA Number10D2235839
Laboratory TypePhysician Office
Certificate Effective DateSeptember 13, 2025
Certificate Expiration DateSeptember 12, 2027
Laboratory DirectorKarl W. Metz
Laboratory Phone(850) 863-8250
Laboratory LocationWhite-Wilson Medical Center, PA127 E Redstone, Crestview, FL 32539
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D2022670

White-Wilson Medical Center - Redstone · Crestview, FL
Active · expires Apr 6, 2027
CLIA Number10D2022670
Laboratory TypePhysician Office
Certificate Effective DateApril 7, 2025
Certificate Expiration DateApril 6, 2027
Laboratory DirectorDr. Vincente Mendez
Laboratory Phone(850) 860-8284
Laboratory LocationWhite-Wilson Medical Center - Redstone130 E Redstone Ave, Crestview, FL 32539
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D2246558

White - Wilson Medical Center, PA · Defuniak Springs, FL
Active · expires Dec 27, 2027
CLIA Number10D2246558
Laboratory TypePhysician Office
Certificate Effective DateDecember 28, 2025
Certificate Expiration DateDecember 27, 2027
Laboratory DirectorVirgil Brown
Laboratory Phone(850) 863-8284
Laboratory LocationWhite - Wilson Medical Center, PA1045 Us-331, Defuniak Springs, FL 32435
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 4

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

TAMMY HOWERTON PA-C
Physician Assistant
1045 US HIGHWAY 331 S
DEFUNIAK SPRINGS, FL 32435
Walton County (850) 892-3366
JENNIFER VITAL WHITFIELD MD
General Practice
1045 US HIGHWAY 331 S
DEFUNIAK SPRINGS, FL 32435
Walton County (850) 892-3366
TOTAL RENAL CARE INC
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
1045 US HIGHWAY 331 S
DEFUNIAK SPRINGS, FL 32435
Walton County (850) 892-1345
DR. DALE A VOLQUARTSEN MD
Pediatrics
1045 US HIGHWAY 331 S
DEFUNIAK SPRINGS, FL 32435
Walton County (850) 892-3366

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 White-Wilson Medical Center, P.A.'s NPI number?

The NPI number for White-Wilson Medical Center, P.A. is 1063267128. It was assigned to this organization in the NPPES registry on April 22, 2024. The provider is also known as White-Wilson Medical Center Dfk.

Where is White-Wilson Medical Center, P.A. located?

White-Wilson Medical Center, P.A. is located at 1045 Us Highway 331 S, Defuniak Springs, FL 32435. The listed phone number is (850) 892-3366.

What is White-Wilson Medical Center, P.A.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Does White-Wilson Medical Center, P.A. hold CLIA laboratory certificates?

Yes. 4 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.

When was this NPI record last updated?

The NPPES record for White-Wilson Medical Center, P.A. was last updated on August 1, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.