Brian Wade Pullam

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN11005354 Issued in FL

Practice address

1049 John Sims Pkwy E
Niceville, FL 32578-2754

Phone

(850) 368-4670

Fax

(850) 378-5237

NPI assigned

Dec 11, 2019

Last updated

Aug 20, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mr. Brian Pullam Professional name

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Headstrong Behavioral Health LLCGroup PAC ID 4688187131, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Headstrong Behavioral Health LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Niceville, FL
  • NPI 1841092137
  Medicare reassignment Care Compare group NPD Authorized official
• Bluewater Behavioral Health Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • Niceville, FL
  • NPI 1922562628
  Medicare reassignment NPD
• Coastline Mental Health LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Niceville, FL
  • NPI 1811729015
  NPD Authorized official

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

{
    "created_epoch": "1576022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1770121535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1723 PINE AVE",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325784600",
            "telephone_number": "850-368-4670",
            "fax_number": "850-378-5237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1049 JOHN SIMS PKWY E",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325782754",
            "telephone_number": "850-368-4670",
            "fax_number": "850-378-5237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULLAM",
        "first_name": "BRIAN",
        "middle_name": "WADE",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-11",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11005354",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11005354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIAN",
            "last_name": "PULLAM",
            "prefix": "MR.",
            "credential": "MSN, APRN, FNP-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Jessica Brooke Rapa, P.A.
• Shannon Raychel

• Psychiatric/Mental Health Nurse Practitioner in Niceville, FL
• Providers in Niceville, 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 Aug 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.