Active NPI
Charli Elizabeth Sullivan, PA
- Physician Assistant
- Panama City Beach, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9117134
- Practice address
- 15415 Panama City Beach Pkwy
Panama City Beach, FL 32413-5409 - Phone
- (850) 588-3589
- NPI assigned
- Jan 26, 2023
- Last updated
- Apr 30, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9117134 | FL | Primary |
Addresses
Primary practice location
15415 Panama City Beach Pkwy
Panama City Beach, FL 32413-5409
Mailing address
15415 Panama City Beach Pkwy
Panama City Beach, FL 32413-5409
Phone (850) 588-3589
Other names 1
- Charli Elizabeth Cubbage
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Mississippi Medical College, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1394 John Sims Pkwy E
Niceville, FL 32578-2208
Phone (850) 517-1920
15415 Panama City Beach Pkwy
Panama City Beach, FL 32413-5409
Phone (850) 588-3589
4713 Hwy 90
Pace, FL 32571-1403
Phone (850) 304-0694
Merit-based Incentive Payment System (MIPS)
- Final score
- 71.83 of 100
- Quality
- 61.85
- Improvement activities
- 40
- Cost
- 76.05
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9117134 | FL | MD | Physician Assistant |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1674691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1777507200000",
"number": "1003522657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15415 PANAMA CITY BEACH PKWY",
"city": "PANAMA CITY BEACH",
"state": "FL",
"postal_code": "324135409",
"telephone_number": "850-588-3589",
"fax_number": "850-588-3593"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15415 PANAMA CITY BEACH PKWY",
"city": "PANAMA CITY BEACH",
"state": "FL",
"postal_code": "324135409",
"telephone_number": "850-588-3589"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "CHARLI",
"middle_name": "ELIZABETH",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-01-26",
"last_updated": "2026-04-30",
"certification_date": "2026-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9117134",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CHARLI",
"last_name": "CUBBAGE",
"middle_name": "ELIZABETH",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Panama City Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.