Individual provider Active NPI

Jay Maggiore, M.D.

  • Family Medicine Physician
  • Panama City, FL
National Provider Identifier
1114019361
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME22443 Issued in FL
Practice address
707 Jenks Ave
Suite a
Panama City, FL 32401-2586
Phone
(850) 747-5272
Fax
(850) 747-5274
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X
Family Medicine Physician 207Q00000X ME22443 FL Primary

Addresses

Primary practice location

707 Jenks Ave
Suite a
Panama City, FL 32401-2586

Mailing address

5619 Gulf Drive
Panama City Beach, FL 32408

Other identifiers 1

IdentifierTypeStateIssuer
37192OtherFLBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME22443FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pancare of Florida, Inc Federally Qualified Health Center (FQHC) Past Accepting new patients
Primary Care Center of Lynn Haven Past Accepting new patients
Primary Care Center, P.a. Past Accepting new patients

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1114019361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5619 GULF DRIVE",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "32408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 JENKS AVE",
            "address_2": "SUITE A",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324012586",
            "telephone_number": "850-747-5272",
            "fax_number": "850-747-5274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGGIORE",
        "first_name": "JAY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME22443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "37192",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.