MMA WELLNESS
NPI 1053892620
Nurse Practitioner - Family in Panama City, FL
About Mma Wellness NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MMA WELLNESS (NPI 1053892620) is a healthcare organization registered as a family in Panama City, Florida and active in the NPI registry since August 2018. The organization lists Mary Margaret Andrews, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mma Wellness is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Mma Wellness, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mma Wellness's NPI number?
The NPI number for Mma Wellness is 1053892620. It was assigned to this organization in the NPPES registry on August 22, 2018.
Where is Mma Wellness located?
Mma Wellness is located at 2428 Jenks Ave, Panama City, FL 32405. The listed phone number is (850) 788-3120.
What is Mma Wellness's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Mma Wellness enrolled in Medicare?
Yes. Mma Wellness is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Mma Wellness?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Mma Wellness, in Certified Nurse Midwife (CNM) and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Mma Wellness was last updated on May 20, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mma Wellness · NPI 1053892620
Family organization in Panama City, Florida. Organization record, active in the CMS NPPES registry since August 22, 2018.
## Identity
- **NPI:** 1053892620 (Entity type: Organization)
- **Enumerated:** August 22, 2018
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** Yes (part of Mma Wellness)
- **Authorized official:** Mary Andrews, PRESIDENT
## Practice location
- **Address:** 2428 JENKS AVE, Panama City, FL 32405-4304
- **Phone:** (850) 788-3120 · **Fax:** (850) 788-3125
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Certified Nurse Midwife (CNM) (1), Nurse Practitioner (1); 1 practice at this address and 2 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 20, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1053892620) · Data from the CMS NPPES public registry.