Organization Active NPI

Bright Pediatrics

  • Primary Care Clinic/Center
  • Panama City, FL
National Provider Identifier
1306202197
Registry record updated Jan 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
ME111081 Issued in FL
Legal business name
BRIGHT PEDIATRICS
Practice address
3520 E 15TH St
Panama City, FL 32404-5831
Phone
(850) 763-4104
Fax
(850) 763-6689
NPI assigned
Jan 8, 2016
Organization subpart
Yes
Parent organization
BRIGHT PEDIATRICSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 8, 2016

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

Authorized official

Name
Sameh M Elamir X, MD
Title
MD
Phone
(850) 257-5147

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X ME111081 FL Primary

Addresses

Primary practice location

3520 E 15TH St
Panama City, FL 32404-5831

Mailing address

340 W 23Rd St
Suite B
Panama City, FL 32405-7600
Phone (850) 257-5147

Other identifiers 1

IdentifierTypeStateIssuer
004305100MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Bright Pediatrics Inc2 organizations share this tax ID, including this one
Part of
Bright Pediatrics Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3520 E 15th St
Panama City, FL 32404
Phone (850) 215-1312

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1452211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452211200000",
    "number": "1306202197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 W 23RD ST",
            "address_2": "SUITE B",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324057600",
            "telephone_number": "850-257-5147",
            "fax_number": "850-257-5886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 E 15TH ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324045831",
            "telephone_number": "850-763-4104",
            "fax_number": "850-763-6689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHT PEDIATRICS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BRIGHT PEDIATRICS",
        "enumeration_date": "2016-01-08",
        "last_updated": "2016-01-08",
        "status": "A",
        "authorized_official_last_name": "ELAMIR",
        "authorized_official_first_name": "SAMEH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "850-257-5147",
        "authorized_official_name_suffix": "X",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "ME111081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004305100",
            "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 Jan 8, 2016; 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.