CHP Panama City FL Tenant Corp.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

CHP PANAMA CITY FL TENANT CORP.

Doing business as

Ssuperior Residences of Panama City Beach

Practice address

95 Grand Heron Dr
Panama City Beach, FL 32407-2553

Phone

(850) 434-3232

NPI assigned

Oct 20, 2022

Organization subpart

No

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

Authorized official

Name

Seth Walker

Title

Cfo, Srim

Phone

(850) 583-7990

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• SSUPERIOR RESIDENCES OF PANAMA CITY BEACH Doing business as

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

CLIA laboratory certificates

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

{
    "created_epoch": "1666224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666224000000",
    "number": "1861119943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2573 BARRINGTON CIR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323086805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 GRAND HERON DR",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324072553",
            "telephone_number": "850-434-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHP PANAMA CITY FL TENANT CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-20",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "SETH",
        "authorized_official_title_or_position": "CFO, SRIM",
        "authorized_official_telephone_number": "850-583-7990"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113534700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SSUPERIOR RESIDENCES OF PANAMA CITY BEACH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Panama City Beach, FL
• Providers in Panama City Beach, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.