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NORTH OKALOOSA CLINIC CORP
NPI 1154990547
Urology in Crestview, FL

Active since June 21, 2021
127 E REDSTONE AVE STE B, CRESTVIEW, FL 32539(850) 689-8100(850) 689-8261 Get Directions Write a Review

NPPES record last updated: March 18, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About North Okaloosa Clinic Corp NPPES

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

NORTH OKALOOSA CLINIC CORP (NPI 1154990547) is a healthcare organization registered as an urology in Crestview, Florida and active in the NPI registry since June 2021. The organization lists Jennifer L Jackson, Sr Dir Prov Enrollment & Onboarding, as its authorized official.

NPPES Registry Identity

NPI1154990547
Entity TypeOrganization
Primary Taxonomy208800000X
Legal Business NameNORTH OKALOOSA CLINIC CORP
Location Address127 E REDSTONE AVE STE BCrestview, FL 32539-5356
Mailing AddressPo Box 689022Franklin, TN 37068-9022 · (615) 465-7211 · Fax (615) 628-6877
Phone(850) 689-8100
Fax(850) 689-8261
Organization SubpartNo
Authorized OfficialJennifer L JacksonSr Dir Prov Enrollment & Onboarding · (615) 465-3334
Enumeration DateJune 21, 2021
Last NPPES UpdateMarch 18, 2022
NPPES CertifiedMarch 18, 2022
✔ NPI 1154990547 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
127 E REDSTONE AVE STE B, Crestview, FL 32539
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Other Names 1

Doing Business AsNorth Okaloosa Clinic Corp

Other Identifiers 1

Medicaid273693406FL

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 MULTIPLE SINGLE SPECIALTY GROUP

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 North Okaloosa Clinic Corp's NPI number?

The NPI number for North Okaloosa Clinic Corp is 1154990547. It was assigned to this organization in the NPPES registry on June 21, 2021.

Where is North Okaloosa Clinic Corp located?

North Okaloosa Clinic Corp is located at 127 E Redstone Ave Ste B, Crestview, FL 32539. The listed phone number is (850) 689-8100.

What is North Okaloosa Clinic Corp's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

When was this NPI record last updated?

The NPPES record for North Okaloosa Clinic Corp was last updated on March 18, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.