Bayside Medical of Northwest FL LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

BAYSIDE MEDICAL OF NORTHWEST FL LLC

Practice address

101 Good Morning St Ste 109B
Port Saint Joe, FL 32456-4765

Phone

(850) 357-8192

Fax

(850) 659-9565

NPI assigned

Sep 6, 2019

Last updated

Mar 18, 2024By 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

Brittany G McCroanNPI 1598326332

Title

Owner

Phone

(850) 357-8192

Specialties & licenses 1

Addresses

Locations

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.

• Brittany Gardner McCroan, APRN

  • Nurse Practitioner
  • Port St Joe, FL
  • NPI 1598326332
  Authorized official Same address or phone

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

{
    "created_epoch": "1567728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710720000000",
    "number": "1821647314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 CORAL DR",
            "city": "PORT ST JOE",
            "state": "FL",
            "postal_code": "324566257",
            "telephone_number": "850-357-8192",
            "fax_number": "850-659-9565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 GOOD MORNING ST STE 109B",
            "city": "PORT SAINT JOE",
            "state": "FL",
            "postal_code": "324564765",
            "telephone_number": "850-357-8192",
            "fax_number": "850-659-9565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSIDE MEDICAL OF NORTHWEST FL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-06",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A",
        "authorized_official_last_name": "MCCROAN",
        "authorized_official_first_name": "BRITTANY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-357-8192"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Wellness LLC
• Lisa Lynn Bell, RCSWI, MSW
• Bio-Medical Applications of Florida, Inc. (Fresenius Kidney Care Port St. Joe)
• Jamie Lynn Brannan, RBT
• Tracie Ann Butts, MS, BCBA
• Joanne Buzzett, M.S. CCC/SLP

• Family Nurse Practitioner in Port Saint Joe, FL
• Providers in Port Saint Joe, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; 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.