Individual provider Active NPI

Bridget Nichole St George

  • Developmentally Disabled Services Day Training Agency
  • Panama City, FL
National Provider Identifier
1508621921
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
License
S326074845220 Issued in FL
Practice address
716 J J Dr
Panama City, FL 32404-8359
Phone
(850) 867-6100
NPI assigned
Feb 15, 2024
Last updated
Feb 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X NU
Developmentally Disabled Services Day Training Agency 251C00000X S326074845220 FL Primary

Addresses

Primary practice location

716 J J Dr
Panama City, FL 32404-8359

Mailing address

716 J J Dr
Panama City, FL 32404-8359
Phone (850) 867-6100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
S326074845220FLMDDevelopmentally Disabled Services Day Training Agency

NPI Registry JSON

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

{
    "created_epoch": "1707955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1508621921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 J J DR",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324048359",
            "telephone_number": "850-867-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 J J DR",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324048359",
            "telephone_number": "850-867-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST GEORGE",
        "first_name": "BRIDGET",
        "middle_name": "NICHOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-15",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "FL",
            "license": "S326074845220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; 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.