MAGNOLIA MEDICAL CLINIC P.A.
NPI 1639281652
Family Medicine in Fort Walton Beach, FL
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 1639281652) is a healthcare organization registered as a family medicine in Fort Walton Beach, Florida and active in the NPI registry since August 2006. The organization maintains 2 additional practice locations and lists Crystal Weatherington, Practice Administrator, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Locations 2
Other Identifiers 2
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Magnolia Medical Clinic P.a. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
12Medicare enrollment records show 12 clinicians reassign Medicare billing to Magnolia Medical Clinic P.A., which bills Medicare for the services they deliver. Of these, 8 practice at this address. They are listed nearest first.
Clinicians by Medicare Specialty 2
Clinicians, nearest first (12)
Fort Walton Beach, FL 32547
Fort Walton Beach, FL 32547
Fort Walton Beach, FL 32547
Fort Walton Beach, FL 32547
Fort Walton Beach, FL 32547
Fort Walton Beach, FL 32547
Fort Walton Beach, FL 32547
Fort Walton Beach, FL 32547
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 1639281652. It was assigned to this organization in the NPPES registry on August 31, 2006.
Where is Magnolia Medical Clinic P.A. located?
Magnolia Medical Clinic P.A. is located at 319 Green Acres Rd Ste 101, Fort Walton Beach, FL 32547. 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.
Is Magnolia Medical Clinic P.A. enrolled in Medicare?
Yes. Magnolia Medical Clinic P.A. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Magnolia Medical Clinic P.A.?
According to the CMS Revalidation Reassignment List (October 2026 release), 12 clinicians in 2 Medicare specialties reassign their Medicare billing to Magnolia Medical Clinic P.A.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Family Practice (8) and Nurse Practitioner (4). Of these, 8 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.
# Magnolia Medical Clinic P.a. · NPI 1639281652
Family Medicine organization in Fort Walton Beach, Florida. Organization record, active in the CMS NPPES registry since August 31, 2006.
## Identity
- **NPI:** 1639281652 (Entity type: Organization)
- **Enumerated:** August 31, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Crystal Weatherington, PRACTICE ADMINISTRATOR
## Practice location
- **Address:** 319 GREEN ACRES RD STE 101, Fort Walton Beach, FL 32547
- **Phone:** (850) 243-7681 · **Fax:** (850) 243-0471
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 12 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (8), Nurse Practitioner (4); 8 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 10, 2025
- **Other identifiers:** Medicaid 254841100 (FL); Other CH5541 (FL)
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Source: [NPI Profile](https://npiprofile.com/npi/1639281652) · Data from the CMS NPPES public registry.