Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Reagan Walker Sanford, PA-C

Individual provider Physician Assistant · NPI 1962209056

Reagan Walker Sanford, PA-C is a Physician Assistant in Fort Walton Beach, Florida. Qualified in 2024, 2 years ago. Practices with Jackson Clinic PA, a 176-clinician group and accepts Medicare assignment. Licensed in Florida and Tennessee.

Years since qualifying
2
Licensed in
FL, TN
In the registry since
2025
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

319 Green Acres Rd # 101
Fort Walton Beach, FL 32547-1170
Phone: (850) 243-7681
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA912410 (FL)
Physician Assistant Taxonomy 363A00000X · Licence 6546 (TN)

Record details

NPI number1962209056
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedFebruary 26, 2025
Last updated in NPPESAugust 4, 2026
Certification dateAugust 4, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Jackson Clinic Pa — 176 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Fort Walton Beach