NPIMap

Organization Active NPI

Blue Sea Mental Health Practitioners LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Palm Coast, FL
National Provider Identifier
1821798414
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
BLUE SEA MENTAL HEALTH PRACTITIONERS LLC
Practice address
381 Palm Coast Pkwy SW Unit 2
Palm Coast, FL 32137-4782
Phone
(386) 232-8089
NPI assigned
Mar 3, 2023
Last updated
Nov 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Authorized official

Name
Cynthia Michelle Baxter, APRNNPI 1033732276
Title
Owner
Phone
(386) 232-8089

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU Primary

Addresses

Primary practice location

381 Palm Coast Pkwy SW Unit 2
Palm Coast, FL 32137-4782

Mailing address

381 Palm Coast Pkwy SW Unit 2
Palm Coast, FL 32137-4782
Phone (386) 232-8089

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250507003526 FL Part B Supplier - Clinic/Group Practice 0446777999 Receives reassigned benefits from 2 practitioners
Practice locations: Palm Coast, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1677801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731369600000",
    "number": "1821798414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "381 PALM COAST PKWY SW UNIT 2",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321374782",
            "telephone_number": "386-232-8089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "381 PALM COAST PKWY SW UNIT 2",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321374782",
            "telephone_number": "386-232-8089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE SEA MENTAL HEALTH PRACTITIONERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-03",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A",
        "authorized_official_last_name": "BAXTER",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-232-8089",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Coast, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.