Organization Active NPI

Primary Care & Functional Medicine Consultants LLC

  • Adult Health Clinical Nurse Specialist
  • Panama City, FL
National Provider Identifier
1598487050
Registry record updated Dec 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X
Legal business name
PRIMARY CARE & FUNCTIONAL MEDICINE CONSULTANTS LLC
Doing business as
Primary Care & Functional Medicine Consultants, LLC
Practice address
508 Airport Rd Ste D
Panama City, FL 32405-4025
Phone
(850) 215-5930
Fax
(850) 353-7006
NPI assigned
Sep 13, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2025

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

Authorized official

Name
Yesenia Ramos, APRNNPI 1356905665
Title
Nurse Practitioner
Phone
(850) 215-5830

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X
Primary Care Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP2300X
Adult Health Clinical Nurse SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 364SA2200X Primary

Addresses

Primary practice location

508 Airport Rd Ste D
Panama City, FL 32405-4025

Mailing address

508 Airport Rd Ste D
Panama City, FL 32405-4025
Phone (850) 215-5830

Other names 2

  • Primary Care & Functional Medicine Consultants, LLC Doing business as
  • Functional Medicine & Holistic Wellness, LLC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221109003225 FL Part B Supplier - Clinic/Group Practice 1153798863 Receives reassigned benefits from 1 practitioner
Practice locations: Panama City, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2270021Primary Care & Functional Medicine508 Airport Rd, Suite D, Panama City, FL 32405Certificate of waiverOct 6, 2026

National Provider Directory

National Provider Directory

Locations

508 Airport Rd
Ste D
Panama City, FL 32405
Phone (850) 215-5830

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1663027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766448000000",
    "number": "1598487050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 AIRPORT RD STE D",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054025",
            "telephone_number": "850-215-5830",
            "fax_number": "850-353-7006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 AIRPORT RD STE D",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054025",
            "telephone_number": "850-215-5930",
            "fax_number": "850-353-7006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE & FUNCTIONAL MEDICINE CONSULTANTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-13",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A",
        "authorized_official_last_name": "RAMOS",
        "authorized_official_first_name": "YESENIA",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "850-215-5830",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "364SA2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Primary Care & Functional Medicine Consultants, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Functional Medicine & Holistic Wellness, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Dec 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.