Active NPI
Amanda A Bragdon
- Pharmacist
- Panama City, FL
National Provider Identifier
1114527702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS58580
- Practice address
- 3621 N Highway 231
Panama City, FL 32404-9743 - Phone
- (850) 914-0200
- Fax
- (850) 914-9125
- NPI assigned
- Nov 1, 2020
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS58580 | FL | Primary |
Addresses
Primary practice location
3621 N Highway 231
Panama City, FL 32404-9743
Mailing address
3621 N Highway 231
Panama City, FL 32404-9743
Phone (850) 914-0200
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS58580 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604188800000",
"number": "1114527702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3621 N HIGHWAY 231",
"city": "PANAMA CITY",
"state": "FL",
"postal_code": "324049743",
"telephone_number": "850-914-0200",
"fax_number": "850-914-9125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3621 N HIGHWAY 231",
"city": "PANAMA CITY",
"state": "FL",
"postal_code": "324049743",
"telephone_number": "850-914-0200",
"fax_number": "850-914-9125"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAGDON",
"first_name": "AMANDA",
"middle_name": "A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-01",
"last_updated": "2020-11-01",
"certification_date": "2020-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS58580",
"primary": true
}
],
"identifiers": [],
"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 Nov 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.