Panama City Neurosurgery PA

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

ME125560 Issued in FL

Legal business name

PANAMA CITY NEUROSURGERY PA

Practice address

15 Doctors Dr
Panama City, FL 32405-4520

Phone

(508) 392-0020

Fax

(850) 392-7897

NPI assigned

Nov 4, 2016

Organization subpart

No

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

Authorized official

Name

Heather Ann Hedstrom, MDNPI 1114190469

Title

Provider/Owner

Phone

(850) 392-0020

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 2

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

• Heather Ann Hedstrom, M.D.

  • Neurological Surgery Physician
  • Panama City, FL
  • NPI 1114190469
  Medicare reassignment NPD Authorized official
• Patrick Mark Kelley, M.D.

  • Plastic Surgery Physician
  • Panama City, FL
  • NPI 1861593949
  NPD

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

{
    "created_epoch": "1478217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730764800000",
    "number": "1437601648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 DOCTORS DR",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054520",
            "telephone_number": "850-392-0020",
            "fax_number": "850-392-7897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 DOCTORS DR",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054520",
            "telephone_number": "508-392-0020",
            "fax_number": "850-392-7897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANAMA CITY NEUROSURGERY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-04",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A",
        "authorized_official_last_name": "HEDSTROM",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PROVIDER/OWNER",
        "authorized_official_telephone_number": "850-392-0020",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "FL",
            "license": "ME125560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Panama City FL Opco LLC
• Panama City General Surgery PA
• Panama City Infectious Disease Associates
• Panama City Infectious Disease Associates PA
• Panama City Inpatient Services LLC
• Panama City Pediatrics PA
• Panama City Pharmacy Inc
• Panama City Plastic Surgery LLC
• Panama City Ppec, LLC
• Panama City Ppec, LLC

• Neurological Surgery Physician in Panama City, FL
• Providers in Panama City, FL by specialty
• Neurological Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.