Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

MS. Tara Rexanne Ennis, MD

Individual provider Specialist · NPI 1700961141

MS. Tara Rexanne Ennis, MD is a General Surgery in Fort Walton Beach, Florida. Graduated from University of Alabama School of Medicine in 2005, 21 years ago. Practices with North Florida Surgeons PA, a 336-clinician group and accepts Medicare assignment. Licensed in Alabama and Florida.

Years since qualifying
21
Trained at
University of Alabama School of Medicine
Licensed in
AL, FL
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1042 Mar Walt Dr
Fort Walton Beach, FL 32547-6645
Phone: (850) 863-0400
Fax: (850) 863-0417
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence ME121048 (FL)
Specialist Taxonomy 174400000X · Licence 28214 (AL)

Record details

NPI number1700961141
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorYes
NPI enumeratedOctober 26, 2006
Last updated in NPPESJuly 7, 2021
Certification dateJuly 7, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL SURGERY
Medical schoolUNIVERSITY OF ALABAMA SCHOOL OF MEDICINE
Graduated 2005 (21 years in practice)
Group practice North Florida Surgeons Pa — 336 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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