Individual provider Active NPI

Tabitha K Nieto

  • Clinical Social Worker
  • Panama City, FL
National Provider Identifier
1982017604
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW14707 Issued in FL
Practice address
2235 E 15TH St
Panama City, FL 32405-6023
Phone
(850) 747-5272
Fax
(850) 747-5274
NPI assigned
Jun 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Clinical Social Worker 1041C0700X SW14707 FL Primary

Addresses

Primary practice location

2235 E 15TH St
Panama City, FL 32405-6023

Mailing address

403 E 11TH St
Panama City, FL 32401-3409
Phone (850) 767-3350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240125001164 FL Practitioner - Clinical Social Worker 9931552072 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pancare of Florida, Inc CurrentSince Aug 1, 2020 Accepting new patients
Pancare of Florida, Inc CurrentSince Dec 20, 2023 Accepting new patients
Pancare of Florida, Inc PastSince Feb 2, 2025 Accepting new patients

Locations

11033 NW State Road 20
Bristol, FL 32321
Phone (850) 643-1155

2309 E 15th St
Panama City, FL 32405
Phone (850) 747-5272

2235 E 15th St
Panama City, FL 32405
Phone (850) 747-5272

403 E 11th St
Panama City Beach, FL 32401
Phone (850) 747-5599

Organizations & group practices 3

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": "1402358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1982017604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 E 11TH ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324013409",
            "telephone_number": "850-767-3350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2235 E 15TH ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324056023",
            "telephone_number": "850-747-5272",
            "fax_number": "850-747-5274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIETO",
        "first_name": "TABITHA",
        "middle_name": "K",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-10",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW14707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.