360 Blue Family Medical LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

360 BLUE FAMILY MEDICAL LLC

Practice address

949 Jenks Ave Ste 6
Panama City, FL 32401-2584

Phone

(904) 853-0809

NPI assigned

Aug 29, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Samantha Blue, DNP, APRN, FNP-BC,NPI 1942729090

Title

Employee

Phone

(850) 319-7345

Specialties & licenses 1

Addresses

Practitioners 1

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

• Samantha Avla Blue, DNP, APRN, FNP-BC

  • Family Nurse Practitioner
  • Panama City Beach, FL
  • NPI 1942729090
  NPD Authorized official

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

{
    "created_epoch": "1693267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694822400000",
    "number": "1487439394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "949 JENKS AVE STE 6",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324012584",
            "telephone_number": "904-853-0809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "949 JENKS AVE STE 6",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324012584",
            "telephone_number": "904-853-0809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "360 BLUE FAMILY MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-29",
        "last_updated": "2023-09-16",
        "certification_date": "2023-09-16",
        "status": "A",
        "authorized_official_last_name": "BLUE",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "EMPLOYEE",
        "authorized_official_telephone_number": "850-319-7345",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, APRN, FNP-BC,"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Panama City, FL
• Providers in Panama City, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2023; 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.