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Active NPI 1336553585 Individual Practitioner Female Practitioner

Carolyn Ann Space , CNP

Nurse Practitioner • Eglin, FL

Professional Overview & Biography Verified Profile Summary

Carolyn Space, CNP is a registered healthcare professional specializing in Nurse Practitioner in Eglin, FL. Practice services are available at 96 MDG under active NPI credentials.

Frequently performed procedures and clinical services include established patient outpatient office visit, blood test, clotting time. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

96 Mdg
307 Boatner Road

Eglin, FL 32542

Telephone 8508839957

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner in Eglin, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.0 Yrs
Regional Practice Density
1 Specialists

Practicing in Eglin, FL (8990 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
58.3% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2018)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
335 218 $210.00 $88.41
99213 Established patient office or other outpatient visit, typically 15 minutes
222 180 $147.00 $59.44
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more
32 30 $278.00 $116.81

Medical Specialties & State Licenses

Nurse Practitioner Primary Specialty

NUCC Taxonomy Code: 363L00000X

State License FL ARNP9457268

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners
NPI 1083804421

Doctor of Medicine (M.D.)

Dr. Aaron Henderson , DO

Internal Medicine - Hematology & Oncology

NPI 1316231129

Doctor of Osteopathic Medicine (D.O.)

Dr. Lisa Rackley , DDS

Dentist - General Practice

NPI 1346687373

Doctor of Dental Surgery

Dr. Nicola Sing , MD

Family Medicine

NPI 1457571408

Doctor of Medicine (M.D.)

James Hatten

Emergency Medicine

NPI 1730620998

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

13 Historical Events
📍
Updated Practice Location September 24, 2018

Registered at 96 MDG, 307 BOATNER ROAD, EGLIN, FL 32542 (Tel: 8508839957)

📍
Updated Business Mailing Address September 24, 2018

Registered at 96MDG, 307 BOATNER ROAD ATTN: CREDENTIALS, EGLIN, FL 32542 (Tel: 8508839957)

NPI Profile Active December 13, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location December 13, 2017

Registered at 1005 MAR WALT DRIVE, PULMONOLOGY DEPARTMENT, FORT WALTON BEACH, FL 325476796 (Tel: 8502430118)

📍
Updated Business Mailing Address December 13, 2017

Registered at 1005 MAR WALT DRIVE, ADMINISTRATION, FORT WALTON BEACH, FL 325476796 (Tel: 8508638105)

👤
Provider Name / Credentials Updated December 13, 2017

Recorded as CAROLYN SPACE, CNP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 13, 2017

Nurse Practitioner (License #ARNP9457268 in FL)

NPI Profile Active January 25, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location January 25, 2016

Registered at 37304 KINGS HWY, BEAVER ISLAND, MI 497825134 (Tel: 2314482275)

📍
Updated Business Mailing Address January 25, 2016

Registered at PO BOX 146, BEAVER ISLAND, MI 497820146 (Tel: 2314482275)

👤
Provider Name / Credentials Updated January 25, 2016

Recorded as CAROLYN SPACE, CNP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 25, 2016

Nurse Practitioner (License #4704312276 in MI)

🟢
Initial NPI Registration & Enumeration June 16, 2014

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1336553585
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 16, 2014
Last Update: September 24, 2018
Sole Proprietor: No

Mailing Address

96mdg, 307 Boatner Road Attn: Credentials

Eglin, FL 32542

Phone: 8508839957

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.