Individual provider Active NPI

Michelle Lavette Bautista, ARNP

  • Family Nurse Practitioner
  • Panama City, FL
National Provider Identifier
1326072398
Registry record updated Feb 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP 2209302 Issued in FL
Practice address
508 Airport Rd Ste G
Panama City, FL 32405-4025
Phone
(850) 215-4455
Fax
(850) 215-4492
NPI assigned
Jul 10, 2006
Last updated
Feb 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP137457 TX
Family Nurse Practitioner 363LF0000X ARNP 2209302 FL Primary

Addresses

Primary practice location

508 Airport Rd Ste G
Panama City, FL 32405-4025

Mailing address

PO Box 639
Panama City, FL 32402-0639
Phone (850) 215-4455

Other practice location 1

5119 Fairmont Pkwy Ste D
Pasadena, TX 77505-3758
Phone (346) 357-3050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041028000833 FL Practitioner - Nurse Practitioner 7517929953 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

508 Airport Rd
Suite G
Panama City, FL 32405-4025
Phone (850) 215-4455

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP 2209302FLMDFamily Nurse Practitioner
AP137457TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Michelle Hines Bautista Arnp Inc CurrentSince Dec 6, 2009 Accepting new patients
Trucause Medical PLLC Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1798 Georgia St
Alford, FL 32420
Phone (850) 526-6727

1532 Jenks Ave
Panama City, FL 32405

2507 Harrison Ave
Unit 201
Panama City, FL 32405
Phone (850) 215-4455

508 Airport Rd
Ste G
Panama City, FL 32405
Phone (850) 215-4455

752 Harrison Ave
Panama City, FL 32401
Phone (850) 215-4455

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1326072398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324020639",
            "telephone_number": "850-215-4455",
            "fax_number": "850-215-4492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 AIRPORT RD STE G",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054025",
            "telephone_number": "850-215-4455",
            "fax_number": "850-215-4492"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5119 Fairmont Pkwy Ste D",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "TX",
            "postal_code": "775053758",
            "country_code": "US",
            "telephone_number": "346-357-3050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "MICHELLE",
        "middle_name": "LAVETTE",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP137457",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP 2209302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.