Gulf Coast Addiction Medicine

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

0301 Issued in FL

Legal business name

GULF COAST ADDICTION MEDICINE

Practice address

277 Forest Park Cir
Panama City, FL 32405-4920

Phone

(850) 522-1516

Fax

(850) 522-1518

NPI assigned

Aug 16, 2016

Organization subpart

No

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

Authorized official

Name

Jennifer Burkett

Title

Office Manager

Phone

(850) 522-1516

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark G. Stavros, M. D.

  • Emergency Medicine Physician
  • Pascagoula, MS
  • NPI 1336103241
  NPD
• Paul Damien Cassidy, LCSW

  • Clinical Social Worker
  • College Station, TX
  • NPI 1487891941
  NPD (past)

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

{
    "created_epoch": "1471305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1407301757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "277 FOREST PARK CIR",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054920",
            "telephone_number": "850-522-1516",
            "fax_number": "850-522-1518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "277 FOREST PARK CIR",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054920",
            "telephone_number": "850-522-1516",
            "fax_number": "850-522-1518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF COAST ADDICTION MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-16",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BURKETT",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "850-522-1516"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "0301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanessa Rae Grimes, L.M.
• Danielle Janine Grontas, APRN
• Angela Gruber
• Guillot Enterprises, LLC
• Stephanie Berlyn Guise, LCSW
• Gulf Coast Anesthesia LLC
• Gulf Coast Autism Clinic, LLC
• Gulf Coast Children'S Advocacy Center Inc.
• Gulf Coast Children'S Advocacy Center, Inc.
• Gulf Coast Counseling Services of Bay County

• Community/Behavioral Health Agency in Panama City, FL
• Providers in Panama City, FL by specialty
• Community/Behavioral Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.