Seaside Primary Care & Psychiatry, LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

SEASIDE PRIMARY CARE & PSYCHIATRY, LLC

Practice address

1931 Ortega St
Navarre, FL 32566-4111

Phone

(850) 684-1410

Fax

(833) 989-0937

NPI assigned

Jun 15, 2020

Organization subpart

No

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

Authorized official

Name

Mrs. Angela Sanders, DNP, APRNNPI 1225396294

Title

Owner/Nurse Practitioner

Phone

(850) 684-1410

Specialties & licenses 4

Addresses

Other names 1

• Seaside Wellness of Navarre Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

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

CLIA laboratory certificates

Practitioners 4

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

• Angela D Sanders, APRN, DNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Navarre, FL
  • NPI 1225396294
  Medicare reassignment Care Compare group NPD Authorized official
• Colleen J Dodson, FNP-BC

  • Family Nurse Practitioner
  • Navarre, FL
  • NPI 1669100459
  Medicare reassignment Care Compare group NPD
• Grace Francis, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Navarre, FL
  • NPI 1023560471
  NPD (past)
• Christopher Kyle Totten, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Fort Walton Beach, FL
  • NPI 1235835224
  NPD (past)

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

{
    "created_epoch": "1592179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665360000000",
    "number": "1730704875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9670 MEADOW WOOD LN",
            "city": "NAVARRE",
            "state": "FL",
            "postal_code": "325662876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1931 ORTEGA ST",
            "city": "NAVARRE",
            "state": "FL",
            "postal_code": "325664111",
            "telephone_number": "850-684-1410",
            "fax_number": "833-989-0937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEASIDE PRIMARY CARE & PSYCHIATRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-15",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "OWNER/NURSE PRACTITIONER",
        "authorized_official_telephone_number": "850-684-1410",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DNP, APRN"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Seaside Wellness of Navarre",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• India Rose Scott, ARNP
• Seachange Mental Health
• Bambi Sealy
• Chet Alan Seaman, DPT
• Anabel Sears, LMT
• Katherine Claire Semmes, L.AC.
• Set Free Womens Refuge
• Christopher Shaffstall
• Heather Marie Shanks, DO
• Shantone V Toliver Davenport Sapphire Counseling

• Psychiatric/Mental Health Nurse Practitioner in Navarre, FL
• Providers in Navarre, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2022; 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.