Active NPI
SMC2
- Family Nurse Practitioner
- Panama City, FL
National Provider Identifier
1235859646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- Legal business name
- SMC2
- Practice address
- 215 W 6TH St
Panama City, FL 32401-2645 - Phone
- (508) 527-6489
- Fax
- (850) 769-6673
- NPI assigned
- Aug 29, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lisa Leanne King
- Title
- Co-Owner, Agent
- Phone
- (850) 527-6489
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | |||
| Family Nurse Practitioner | 363LF0000X | Primary |
Addresses
Primary practice location
215 W 6TH St
Panama City, FL 32401-2645
Mailing address
4832 Long Lake Ridge Dr
Chipley, FL 32428-3670
Phone (850) 527-6489
Other names 1
- Southern-Breeze Medical Care
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Surgery Physician
- Panama City, FL
- NPI 1982766135
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661731200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1661731200000",
"number": "1235859646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4832 LONG LAKE RIDGE DR",
"city": "CHIPLEY",
"state": "FL",
"postal_code": "324283670",
"telephone_number": "850-527-6489"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 W 6TH ST",
"city": "PANAMA CITY",
"state": "FL",
"postal_code": "324012645",
"telephone_number": "508-527-6489",
"fax_number": "850-769-6673"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SMC2",
"organizational_subpart": "NO",
"enumeration_date": "2022-08-29",
"last_updated": "2022-08-29",
"certification_date": "2022-08-29",
"status": "A",
"authorized_official_last_name": "KING",
"authorized_official_first_name": "LISA",
"authorized_official_middle_name": "LEANNE",
"authorized_official_title_or_position": "CO-OWNER, AGENT",
"authorized_official_telephone_number": "850-527-6489"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Southern-Breeze Medical Care",
"code": "3",
"type": "Doing Business As"
}
]
}
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 Aug 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.