Individual provider Active NPI

Angela J Pearson, N.P.

  • Nurse Practitioner
  • Panama City, FL
National Provider Identifier
1013267608
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209009710 Issued in IL
Practice address
2505 Harrison Ave
Panama City, FL 32405-4464
Phone
(850) 233-3376
Fax
(850) 522-8354
NPI assigned
Sep 12, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209009710 IL Primary
Nurse Practitioner 363L00000X 11013811 FL
Registered Nurse 163W00000X 041358950 IL

Addresses

Primary practice location

2505 Harrison Ave
Panama City, FL 32405-4464

Mailing address

2505 Harrison Ave
Panama City, FL 32405-4464
Phone (850) 233-3376

Other practice location 1

75 Origins Main St Ste 203
Watersound, FL 32461-8826
Phone (850) 233-3376

Other practice location 2

3089 Gulf Breeze Pkwy
Gulf Breeze, FL 32563-3216
Phone (850) 233-3376

Other practice location 3

2053 Fountain Professional Ct
Navarre, FL 32566-5109
Phone (850) 233-3376

Other practice location 4

5952 Berryhill Rd
Milton, FL 32570-4009
Phone (850) 233-3376

Other practice location 5

3120 Southride Ln
Bonifay, FL 32425-3325
Phone (850) 233-3376

Other identifiers 1

IdentifierTypeStateIssuer
APRN11013811OtherFLNP

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210817000297 FL Practitioner - Nurse Practitioner 3971754417 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Dermatology Group PAGroup PAC ID 9931277233, 45 clinicians

Practice addresses (Care Compare)

2505 Harrison Ave
Panama City, FL 32405-4464
Phone (850) 233-3376

Merit-based Incentive Payment System (MIPS)

Final score
97.45 of 100Reported as group
Promoting interoperability
97
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
041358950ILMDRegistered Nurse
11013811FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Dermatology Group PA CurrentSince Aug 10, 2021 Accepting new patients
Vascular Associates LLC Past Accepting new patients
Physicians Immediate Care North Chicago LLC PastSince Oct 27, 2025 Accepting new patients

Locations

3120 Southride Ln
Bonifay, FL 32425
Phone (850) 547-4440

3089 Gulf Breeze Pkwy
Gulf Breeze, FL 32563
Phone (850) 203-3790

5952 Berryhill Rd
Milton, FL 32570
Phone (850) 623-0323

2505 Harrison Ave
Panama City, FL 32405
Phone 85023333762619

12907 Panama City Beach Pkwy
Panama City Beach, FL 32407

82 Mack Bayou Loop
Santa Rsa Bch, FL 32459
Phone (850) 622-0600

75 Origins Main St
Ste 203204
Watersound, FL 32461

75 Origins Main St
Ste 203
Watersound, FL 32461

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1347408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1013267608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 HARRISON AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054464",
            "telephone_number": "850-233-3376",
            "fax_number": "850-522-8354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 HARRISON AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054464",
            "telephone_number": "850-233-3376",
            "fax_number": "850-522-8354"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Origins Main St Ste 203",
            "address_purpose": "LOCATION",
            "city": "Watersound",
            "state": "FL",
            "postal_code": "324618826",
            "country_code": "US",
            "telephone_number": "850-233-3376",
            "fax_number": "850-522-8354",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3089 Gulf Breeze Pkwy",
            "address_purpose": "LOCATION",
            "city": "Gulf Breeze",
            "state": "FL",
            "postal_code": "325633216",
            "country_code": "US",
            "telephone_number": "850-233-3376",
            "fax_number": "850-522-8354",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2053 Fountain Professional Ct",
            "address_purpose": "LOCATION",
            "city": "Navarre",
            "state": "FL",
            "postal_code": "325665109",
            "country_code": "US",
            "telephone_number": "850-233-3376",
            "fax_number": "850-522-8354",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5952 Berryhill Rd",
            "address_purpose": "LOCATION",
            "city": "Milton",
            "state": "FL",
            "postal_code": "325704009",
            "country_code": "US",
            "telephone_number": "850-233-3376",
            "fax_number": "850-522-8354",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3120 Southride Ln",
            "address_purpose": "LOCATION",
            "city": "Bonifay",
            "state": "FL",
            "postal_code": "324253325",
            "country_code": "US",
            "telephone_number": "850-233-3376",
            "fax_number": "850-522-8354",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "ANGELA",
        "middle_name": "J",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-12",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209009710",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11013811",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041358950",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP",
            "identifier": "APRN11013811",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.