Individual provider Active NPI

Bryan Pruess, ARNP

  • Family Nurse Practitioner
  • Panama City, FL
National Provider Identifier
1679071799
Registry record updated Sep 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN9246003 Issued in FL
Practice address
2614 Jenks Ave
Panama City, FL 32405-4311
Phone
(850) 215-3000
Fax
(850) 215-3150
NPI assigned
Jan 23, 2018
Last updated
Sep 8, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2023

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 APRN9246003 FL Primary

Addresses

Primary practice location

2614 Jenks Ave
Panama City, FL 32405-4311

Mailing address

406 Wisteria St
Panama City Beach, FL 32407-3018
Phone (850) 896-6838

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
I20180308000840 FL Practitioner - Nurse Practitioner 6002177078 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN9246003FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC CurrentSince Mar 1, 2023 Accepting new patients
FL Neuro Pain and Spine Center, .P.a. CurrentSince Jul 1, 2021 Accepting new patients
Cep America, LLC CurrentSince Mar 1, 2023 Accepting new patients
Panhandle Emergency Physicians a Div of Sacred Heart Hosp Pensacola CurrentSince Feb 1, 2018 Accepting new patients
FL Neuro Pain and Spine Center, .P.a. Current Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

7800 US Highway 98 W
Miramar Beach, FL 32550
Phone (850) 267-1603

2614 Jenks Ave
Panama City, FL 32405
Phone (850) 215-3000

1008 Jenks Ave
Panama City, FL 32401
Phone (850) 215-3000

5151 N 9th Ave
Pensacola, FL 32504
Phone (850) 202-4700

Organizations & group practices 5

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": "1516665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1679071799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 WISTERIA ST",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324073018",
            "telephone_number": "850-896-6838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2614 JENKS AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054311",
            "telephone_number": "850-215-3000",
            "fax_number": "850-215-3150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUESS",
        "first_name": "BRYAN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-23",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9246003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.