Salt and Ivy Gulf LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SALT AND IVY GULF LLC

Practice address

101 Good Morning St Ste 109B
Port St Joe, FL 32456-4765

Phone

(850) 357-8192

Fax

(850) 659-9565

NPI assigned

Mar 18, 2024

Organization subpart

No

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

Authorized official

Name

Mrs. Brittany Gardner McCroan, APRN-CNPI 1598326332

Title

Nurse Practitioner/ Owner

Phone

(850) 357-8192

Specialties & licenses 1

Addresses

Other names 1

• Salt and Ivy Health and Wellness Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brittany Gardner McCroan, APRN

  • Nurse Practitioner
  • Port St Joe, FL
  • NPI 1598326332
  NPD Authorized official

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

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710720000000",
    "number": "1073372124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 CORAL DR",
            "city": "PORT ST JOE",
            "state": "FL",
            "postal_code": "324566257",
            "telephone_number": "850-357-8192",
            "fax_number": "850-659-9565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 GOOD MORNING ST STE 109B",
            "city": "PORT ST JOE",
            "state": "FL",
            "postal_code": "324564765",
            "telephone_number": "850-357-8192",
            "fax_number": "850-659-9565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALT AND IVY GULF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-18",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A",
        "authorized_official_last_name": "MCCROAN",
        "authorized_official_first_name": "BRITTANY",
        "authorized_official_middle_name": "GARDNER",
        "authorized_official_title_or_position": "NURSE PRACTITIONER/ OWNER",
        "authorized_official_telephone_number": "850-357-8192",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APRN-C"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Salt and Ivy Health and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Judith Renfroe Romiti, RN
• Jeffrey Robert Root, M.D.
• Heidi S Rosasco, PT
• Sacred Heart on the Gulf
• Sacred Heart on the Gulf
• Braden J Shaffer, APN
• Shivam Shah, MD
• Leo Haywood Shealy, LMHC
• Shoreline Center for Exceptional Students, LLC
• Shoreline Medical Group, P.a.

• Family Medicine Physician in Port St Joe, FL
• Providers in Port St Joe, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.