Individual provider Active NPI

Neethu Kattasseri Varghese, ARNP

  • Family Nurse Practitioner
  • Panama City, FL
National Provider Identifier
1629792742
Registry record updated Oct 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11022182 Issued in FL
Practice address
501 Airport Rd
Panama City, FL 32405-4010
Phone
(850) 913-9488
NPI assigned
Oct 3, 2022
Last updated
Oct 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11022182 FL Primary

Addresses

Primary practice location

501 Airport Rd
Panama City, FL 32405-4010

Mailing address

564 Fanning Bayou Dr
Panama City, FL 32409-1741
Phone (757) 602-6433

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
11022182FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Consult Care Pain Medicine P a. Single Specialty PastSince Oct 9, 2022 Accepting new patients

Organizations & group practices 1

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": "1664755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1629792742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "564 FANNING BAYOU DR",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324091741",
            "telephone_number": "757-602-6433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 AIRPORT RD",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054010",
            "telephone_number": "850-913-9488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATTASSERI VARGHESE",
        "first_name": "NEETHU",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-03",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11022182",
            "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 Oct 3, 2022; 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.