NPIMap

Organization Active NPI

Cep America LLC

  • Emergency Medicine Physician
  • Panama City Beach, FL
National Provider Identifier
1114789609
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
CEP AMERICA LLC
Practice address
11111 Panama City Beach Pkwy
Panama City Beach, FL 32407-2448
Phone
(850) 804-2900
NPI assigned
Jan 29, 2024
Last updated
Feb 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Authorized official

Name
David Birdsall, MDNPI 1164445615
Title
Coo of Clinical Operations
Phone
(510) 350-2600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

11111 Panama City Beach Pkwy
Panama City Beach, FL 32407-2448

Mailing address

1601 Cummins Dr Ste D
Modesto, CA 95358-6411
Phone (510) 851-7501

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230131002198 FL Part B Supplier - Clinic/Group Practice 6608056171 Receives reassigned benefits from 428 practitioners
18 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Panama City Beach, FL; Saint Johns, FL; Port St Joe, FL; Pensacola, FL; Panama City, FL; Pace, FL; Miramar Beach, FL; Middleburg, FL…

Other NPIs on the same Medicare enrollment 18

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 18

National Provider Directory

National Provider Directory

Locations

13139 Sorrento Rd
Pensacola, FL 32507
Phone (850) 492-0543

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1706486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707350400000",
    "number": "1114789609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 CUMMINS DR STE D",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953586411",
            "telephone_number": "510-851-7501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11111 PANAMA CITY BEACH PKWY",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324072448",
            "telephone_number": "850-804-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEP AMERICA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-29",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A",
        "authorized_official_last_name": "BIRDSALL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "COO OF CLINICAL OPERATIONS",
        "authorized_official_telephone_number": "510-350-2600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.