Crestview Hospital Corporation
NPI 1902854425ActiveOrganization· Family Medicine· Defuniak Springs, FL
Family Medicine in Defuniak Springs, Florida, registered in NPPES in May 2006, part of Crestview Hospital Corporation. The authorized official on file is Jennifer L. Jackson, Sr Dir Onboarding & Prov Enrollment.
Overview
| NPI | 1902854425 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Crestview Hospital Corporation |
| NPI issued | May 5, 2006 |
| Last updated in NPPES | Mar 18, 2022 |
| Certified by provider | Feb 14, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | — | — |
| Internal Medicine | 207R00000X | — | — |
| Clinic/Center, Rural Health | 261QR1300X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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