Individual provider Active NPI

Amanda Bercey, PHARMD

  • Pharmacist
  • Santa Rosa Beach, FL
National Provider Identifier
1962783787
Registry record updated Nov 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
019517 Issued in LA
Practice address
2050 W County Highway 30a # M1-106
Santa Rosa Beach, FL 32459-0187
Phone
(850) 622-3313
Fax
(850) 622-3255
NPI assigned
Sep 7, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 019517 LA Primary

Addresses

Primary practice location

2050 W County Highway 30a # M1-106
Santa Rosa Beach, FL 32459-0187

Mailing address

238 N Sand Palm Rd FL 32439
Freeport, FL 32439-3731
Phone (504) 330-1405

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
019517LAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Specialty Pharmacy LLC PastSince Dec 6, 2022 Accepting new patients
South Walton Pharmacy LLC PastSince Dec 6, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1315353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1962783787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "238 N SAND PALM RD FL 32439",
            "city": "FREEPORT",
            "state": "FL",
            "postal_code": "324393731",
            "telephone_number": "504-330-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 W COUNTY HIGHWAY 30A # M1-106",
            "city": "SANTA ROSA BEACH",
            "state": "FL",
            "postal_code": "324590187",
            "telephone_number": "850-622-3313",
            "fax_number": "850-622-3255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERCEY",
        "first_name": "AMANDA",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-07",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "019517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2022; 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.