Individual provider Active NPI

Sara Ehab Mohamed, DNP-FNP

  • Family Nurse Practitioner
  • Panama City, FL
National Provider Identifier
1417784893
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11034916 Issued in FL
Practice address
2202 State Ave Ste 303
Panama City, FL 32405-4590
Phone
(850) 872-3939
NPI assigned
Sep 18, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11034916 FL Primary

Addresses

Primary practice location

2202 State Ave Ste 303
Panama City, FL 32405-4590

Mailing address

4002 Torino Way
Panama City, FL 32405-3218

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
I20241021001054 FL Practitioner - Nurse Practitioner 0244762870 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gulf Coast Multispeciality Services, LLCGroup PAC ID 2466555339, 19 clinicians

Practice addresses (Care Compare)

2202 State Ave
Suite 303
Panama City, FL 32405-4590
Phone (850) 872-3939

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11034916FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf Coast Multispeciality Services, LLC CurrentSince Oct 21, 2024 Accepting new patients

Locations

2202 State Ave
Ste 303
Panama City, FL 32405
Phone (850) 784-1856

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • Direct secure messaging: sara.mohamed@hca5.eclinicaldirectplus.com

Organizations & group practices 1

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1726617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1417784893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4002 TORINO WAY",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324053218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 STATE AVE STE 303",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054590",
            "telephone_number": "850-872-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAMED",
        "first_name": "SARA",
        "middle_name": "EHAB",
        "credential": "DNP-FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-18",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11034916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.