Individual provider Active NPI

Jessica Lauren Daube, APRN

  • Nurse Practitioner
  • Panama City, FL
National Provider Identifier
1043802176
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11011192 Issued in FL
Practice address
200 Doctors Dr
Panama City, FL 32405-4559
Phone
(850) 784-7722
NPI assigned
Feb 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11011192 FL Primary

Addresses

Primary practice location

200 Doctors Dr
Panama City, FL 32405-4559

Mailing address

200 Doctors Dr
Panama City, FL 32405-4559
Phone (850) 784-7722

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
I20210311001659 FL Practitioner - Nurse Practitioner 2062828379 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ENT and Allergy Associates of Florida, LLCGroup PAC ID 0042292849, 227 clinicians

Practice addresses (Care Compare)

200 Doctors Dr
Panama City, FL 32405-4559
Phone (850) 784-7722

Hospital & facility affiliations

  • HCA Florida Gulf Coast Hospital Hospital, Panama City, FL, CCN 100242
  • Ascension Sacred Heart Bay Hospital, Panama City, FL, CCN 100026
  • Ascension Sacred Heart Gulf Hospital, Port Saint Joe, FL, CCN 100313

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11011192FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
ENT and Allergy Associates of Florida, LLC CurrentSince Jan 25, 2021 Accepting new patients

Locations

6421 Congress Ave
Ste 113
Boca Raton, FL 33487
Phone (561) 338-3267

900 NW 13th St
Ste 206
Boca Raton, FL 33486
Phone (561) 338-3267

1303 Mosley Dr
Lynn Haven, FL 32444
Phone (850) 271-5996

200 Doctors Dr
Panama City, FL 32405
Phone (850) 784-7722

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 and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1612915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1043802176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 DOCTORS DR",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054559",
            "telephone_number": "850-784-7722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 DOCTORS DR",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054559",
            "telephone_number": "850-784-7722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUBE",
        "first_name": "JESSICA",
        "middle_name": "LAUREN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-10",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11011192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.