Individual provider Active NPI

Amber McKenzie, ARNP

  • Adult Health Nurse Practitioner
  • Panama City, FL
National Provider Identifier
1528433117
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
9239601 Issued in FL
Practice address
620 McKenzie Ave
Panama City, FL 32401-3062
Phone
(850) 518-7378
Fax
(850) 640-4187
NPI assigned
Dec 8, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 9239601 FL
Registered Nurse 163W00000X 1-148775 AL
Adult Health Nurse Practitioner 363LA2200X 9239601 FL Primary
Gerontology Nurse Practitioner 363LG0600X 9239601 FL

Addresses

Primary practice location

620 McKenzie Ave
Panama City, FL 32401-3062

Mailing address

620 McKenzie Ave
Panama City, FL 32401-3062
Phone (850) 518-7378

Other identifiers 1

IdentifierTypeStateIssuer
020109300MedicaidFL

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
I20170307001857 FL Practitioner - Nurse Practitioner 0941584106 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emerald Coast Sleep DiagnosticsGroup PAC ID 9133559396, 2 clinicians

Practice addresses (Care Compare)

620 McKenzie Ave
Panama City, FL 32401-3062
Phone (850) 518-7378

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-148775ALMDRegistered Nurse
9239601FLMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emerald Coast Sleep Diagnostics Adult Health CurrentSince May 17, 2020 Accepting new patients
Emerald Coast Sleep Diagnostics CurrentSince Mar 26, 2020 Accepting new patients

Locations

3368 Highway 280
Ste G15
Alexander City, AL 35010
Phone 2563291114104

620 McKenzie Ave
Panama City, FL 32401
Phone (850) 518-7378

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1449532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1528433117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 MCKENZIE AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324013062",
            "telephone_number": "850-518-7378",
            "fax_number": "850-640-4187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 MCKENZIE AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324013062",
            "telephone_number": "850-518-7378",
            "fax_number": "850-640-4187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "AMBER",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-08",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "9239601",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-148775",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "9239601",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "9239601",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020109300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.