Southern Breeze Healthcare

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SOUTHERN BREEZE HEALTHCARE

Practice address

4556 E Hwy 20
Suite 105
Niceville, FL 32578

Phone

(910) 988-1326

NPI assigned

Oct 3, 2018

Organization subpart

No

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

Authorized official

Name

Gary Bullard, P.A.

Title

Physician Assistant

Phone

(910) 988-1326

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Interoperability endpoints

• Direct secure messaging: sgillett@southernbreezehealthcare.com
• FHIR API: https://api.platform.athenahealth.com/18649/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1538524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609804800000",
    "number": "1376028563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4556 E HWY 20",
            "address_2": "SUITE 105",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "32578",
            "telephone_number": "910-988-1326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4556 E HWY 20",
            "address_2": "SUITE 105",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "32578",
            "telephone_number": "910-988-1326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN BREEZE HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-03",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A",
        "authorized_official_last_name": "BULLARD",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "PHYSICIAN ASSISTANT",
        "authorized_official_telephone_number": "910-988-1326",
        "authorized_official_credential": "P.A."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "SGILLETT@SOUTHERNBREEZEHEALTHCARE.COM",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4556 E HWY 20",
            "address_2": "Suite 105",
            "city": "Niceville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "32578",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kimberly Smith
• Mitchell Smith, PHARMD
• Joan Marie Sonnier, M.S. , RMFT I
• Rustin G Sorensen, PA-C
• Southcoast Allergy PA
• Southland Emergency Medical Services of FL PL
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• Speech at the Beach
• Rachel Sperry, OTD, OTR/L
• Gregory Spires, APRN FNP-C

• Family Medicine Physician in Niceville, FL
• Providers in Niceville, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2021; 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.