North Florida Obstetric & GYN Center PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME48532 Issued in FL

Legal business name

NORTH FLORIDA OBSTETRIC & GYN CENTER PA

Practice address

1937 Harrison Ave
Panama City, FL 32405-4543

Phone

(850) 784-6877

Fax

(850) 785-5346

NPI assigned

Jan 5, 2007

Last updated

Jan 15, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Bryce Vincent Jackson, M.D.NPI 1467423632

Title

President

Phone

(850) 784-6877

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• DR BRYCE V JACKSON Other name

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 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bryce V Jackson, M.D.

  • Obstetrics & Gynecology Physician
  • Panama City, FL
  • NPI 1467423632

  Specialist

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389744000000",
    "number": "1790832210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1937 HARRISON AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054543",
            "telephone_number": "850-784-6877",
            "fax_number": "850-785-5346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1937 HARRISON AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054543",
            "telephone_number": "850-784-6877",
            "fax_number": "850-785-5346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH FLORIDA OBSTETRIC & GYN CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2014-01-15",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "BRYCE",
        "authorized_official_middle_name": "VINCENT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-784-6877",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME48532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "043532500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "03638",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DR BRYCE V JACKSON",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Laura Lea Nofal, PAC
• Gina Maria Nolan, ARNP
• Morgan Michelle Noles
• Kandace Norris, RN
• North Bay Imaging LLC
• North Florida Perinatal Associates, Inc
• North Florida Surgeons, PA (NFS Spine, LLC)
• North Florida Surgeons, PA (NFS Northwest Florida Spine, LLC)
• North Florida Surgeons, PA (North Florida Surgeons Orthopaedic Associates, LLC)
• North Florida Surgeons, PA

• Specialist in Panama City, FL
• Providers in Panama City, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2014; 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.