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OKALOOSA CARDIOLOGY P A
NPI 1144270240
Internal Medicine - Cardiovascular Disease in Crestview, FL

Active since May 11, 2006CLIA Certified · 2 labs
129 E REDSTONE AVE, SUITE A, CRESTVIEW, FL 32539(850) 682-7212 Get Directions Write a Review

NPPES record last updated: August 25, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Okaloosa Cardiology P A NPPES

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

OKALOOSA CARDIOLOGY P A (NPI 1144270240) is a healthcare organization registered as a cardiovascular disease in Crestview, Florida and active in the NPI registry since May 2006. The organization holds 2 active CLIA laboratory certificates and lists Donna M Gibson, Billing Manager, as its authorized official.

NPPES Registry Identity

NPI1144270240
Entity TypeOrganization
Primary Taxonomy207RC0000X
Legal Business NameOKALOOSA CARDIOLOGY P A
Location Address129 E REDSTONE AVE, SUITE ACrestview, FL 32539-5350
Mailing Address129 E Redstone Ave, Suite ACrestview, FL 32539-5350 · (850) 682-7212
Phone(850) 682-7212
Organization SubpartNo
Authorized OfficialDonna M GibsonBilling Manager · (850) 682-7212
Enumeration DateMay 11, 2006
Last NPPES UpdateAugust 25, 2011
✔ NPI 1144270240 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Also ListedSurgery · Vascular SurgeryTaxonomy 2086S0129X
129 E REDSTONE AVE, Crestview, FL 32539
Open in Google Maps ↗

Other Identifiers 2

Medicare ID-Type Unspecified24136FL · Medicare Number
Medicaid258928100FL

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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), Wellpoint.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 Waiver 10D0976637

Okaloosa Cardiology PA · Crestview, FL
Active · expires Aug 9, 2026
CLIA Number10D0976637
Laboratory TypePhysician Office
Certificate Effective DateAugust 10, 2024
Certificate Expiration DateAugust 9, 2026
Laboratory DirectorMark J. Kutzenstein
Laboratory Phone(850) 678-7522
Laboratory LocationOkaloosa Cardiology PA129 E Redstone Aveune Suite A, 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 10D2121624

Okaloosa Cardiology PA Okaloosa Heart And Vascular Center · Defuniak Springs, FL
Active · expires Nov 8, 2026
CLIA Number10D2121624
Laboratory TypePhysician Office
Certificate Effective DateNovember 9, 2024
Certificate Expiration DateNovember 8, 2026
Laboratory DirectorMark J. Katzenstein
Laboratory Phone(850) 682-7212
Laboratory LocationOkaloosa Cardiology PA Okaloosa Heart And Vascular Center1045 Us Hwy 331 S, Defuniak Springs, FL 32435
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

MRS. KELLY SMIDEBUSH ARNP
Nurse Practitioner
129 E REDSTONE AVE, SUITE A
CRESTVIEW, FL 32539
Okaloosa County (850) 682-7212
JUAN CARLOS ZARATE MD
Internal Medicine (Cardiovascular Disease)
129 E REDSTONE AVE, SUITE A
CRESTVIEW, FL 32539
Okaloosa County (850) 682-7212

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 Okaloosa Cardiology P A's NPI number?

The NPI number for Okaloosa Cardiology P A is 1144270240. It was assigned to this organization in the NPPES registry on May 11, 2006.

Where is Okaloosa Cardiology P A located?

Okaloosa Cardiology P A is located at 129 E Redstone Ave Suite A, Crestview, FL 32539. The listed phone number is (850) 682-7212.

What is Okaloosa Cardiology P A's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Does Okaloosa Cardiology P A 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 Okaloosa Cardiology P A accept?

Health plans from Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and Wellpoint list Okaloosa Cardiology 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 Okaloosa Cardiology P A was last updated on August 25, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.