Active NPI
Beaches Family Practice Center
- Specialist
- Panama City, FL
National Provider Identifier
1629114541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- ME26512
- Legal business name
- BEACHES FAMILY PRACTICE CENTER
- Practice address
- 230 S Highway 79
Panama City, FL 32413-2151 - Phone
- (850) 234-8811
- Fax
- (850) 234-8556
- NPI assigned
- Jan 29, 2007
- Last updated
- Jan 28, 2008
- Organization subpart
- Yes
- Parent organization
- BEACHES FAMILY PRACTICE CENTER
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Ernest George Haslam, M.D.
- Title
- Physician
- Phone
- (850) 234-8811
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | ME26512 | FL | Primary |
Addresses
Primary practice location
230 S Highway 79
Panama City, FL 32413-2151
Mailing address
230 S Highway 79
Panama City, FL 32413-2151
Phone (850) 234-8811
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 76011 | Other | FL | BLUE CROSS |
| 3806 | Other | FL | FLORIDA MEDICARE |
National Provider Directory
National Provider Directory- Part of
- Beaches Family Practice
Locations
230 S Arnold Rd
Panama City, FL 32413
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170028800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1201478400000",
"number": "1629114541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "230 S HIGHWAY 79",
"city": "PANAMA CITY",
"state": "FL",
"postal_code": "324132151",
"telephone_number": "850-234-8811",
"fax_number": "850-234-8556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "230 S HIGHWAY 79",
"city": "PANAMA CITY",
"state": "FL",
"postal_code": "324132151",
"telephone_number": "850-234-8811",
"fax_number": "850-234-8556"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BEACHES FAMILY PRACTICE CENTER",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "BEACHES FAMILY PRACTICE CENTER",
"enumeration_date": "2007-01-29",
"last_updated": "2008-01-28",
"status": "A",
"authorized_official_last_name": "HASLAM",
"authorized_official_first_name": "ERNEST",
"authorized_official_middle_name": "GEORGE",
"authorized_official_title_or_position": "PHYSICIAN",
"authorized_official_telephone_number": "850-234-8811",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist",
"state": "FL",
"license": "ME26512",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "76011",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FLORIDA MEDICARE",
"identifier": "3806",
"state": "FL"
}
],
"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 Jan 28, 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.