Organization Active NPI

Beach Primary Care LLC

Doing business as West End of the Beach Primary Care

  • Internal Medicine Physician
  • Panama City, FL
National Provider Identifier
1568409837
Registry record updated Jan 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
BEACH PRIMARY CARE LLC
Doing business as
West End of the Beach Primary Care
Practice address
17320 Panama City Beach Pkwy
Suite 105
Panama City, FL 32413-2024
Phone
(850) 234-8175
Fax
(850) 234-8868
NPI assigned
Jun 2, 2006
Last updated
Jan 10, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2008

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

Authorized official

Name
Mickey Pickler
Title
VP
Phone
(850) 234-8175

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

17320 Panama City Beach Pkwy
Suite 105
Panama City, FL 32413-2024

Mailing address

17320 Panama City Beach Pkwy
Suite 105
Panama City, FL 32413-2024
Phone (850) 234-8175

Other names 1

  • West End of the Beach Primary Care Doing business as

National Provider Directory

National Provider Directory

Locations

13200 Panama City Beach Pkwy
Panama City, FL 32407
Phone (850) 234-8175

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199923200000",
    "number": "1568409837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17320 PANAMA CITY BEACH PKWY",
            "address_2": "SUITE 105",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324132024",
            "telephone_number": "850-234-8175",
            "fax_number": "850-234-8868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17320 PANAMA CITY BEACH PKWY",
            "address_2": "SUITE 105",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324132024",
            "telephone_number": "850-234-8175",
            "fax_number": "850-234-8868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACH PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-02",
        "last_updated": "2008-01-10",
        "status": "A",
        "authorized_official_last_name": "PICKLER",
        "authorized_official_first_name": "MICKEY",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "850-234-8175"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West End of the Beach Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 10, 2008; 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.