OrganizationActive
Smc2
NPI 1235859646 · Family Nurse Practitioner · Panama City, FL
Provider details
- NPI number
- 1235859646
- Entity type
- Organization
- Primary specialty
- Family Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Lisa King, Co-Owner, Agent(850) 527-6489
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
- Nurse Practitioner363L00000X
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Established profile(60/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
215 W 6th St
Panama City, FL 32401-2645
Phone: (508) 527-6489
Fax: (850) 769-6673
Street-level locationGet directions
Mailing address
4832 Long Lake Ridge Dr
Chipley, FL 32428-3670
Other names (DBA / former)
- Doing business as
- Southern-Breeze Medical Care
Registry dates
- Enumerated
- 2022-08-29
- Last updated
- 2022-08-29
- Certified
- 2022-08-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.