SOUTHERN BREEZE PRIMARY CARE, LLC
NPI 1114734183
Clinic/Center - Primary Care in Panama City, FL
About Southern Breeze Primary Care, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTHERN BREEZE PRIMARY CARE, LLC (NPI 1114734183) is a healthcare organization registered as a primary care in Panama City, Florida and active in the NPI registry since December 2024. The organization holds a CLIA Waiver certificate valid through January 13, 2027 and lists Lisa Leanne King, Administrator, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Southern Breeze Primary Care, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Southern Breeze Primary Care, LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 10D2316851
Southern Breeze Primary Care LLC · Panama City, FLFrequently 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 Southern Breeze Primary Care, LLC's NPI number?
The NPI number for Southern Breeze Primary Care, LLC is 1114734183. It was assigned to this organization in the NPPES registry on December 13, 2024.
Where is Southern Breeze Primary Care, LLC located?
Southern Breeze Primary Care, LLC is located at 107 W 19th St, Panama City, FL 32405. The listed phone number is (850) 527-6489.
What is Southern Breeze Primary Care, LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Southern Breeze Primary Care, LLC enrolled in Medicare?
Yes. Southern Breeze Primary Care, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Southern Breeze Primary Care, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Southern Breeze Primary Care, LLC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Southern Breeze Primary Care, LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 10D2316851) is associated with this NPI, valid through January 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Southern Breeze Primary Care, LLC accept?
Health plans from Florida Blue (BlueCross BlueShield FL) list Southern Breeze Primary Care, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Southern Breeze Primary Care, LLC was last updated on December 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.
# Southern Breeze Primary Care, Llc · NPI 1114734183
Primary Care organization in Panama City, Florida. Organization record, active in the CMS NPPES registry since December 13, 2024.
## Identity
- **NPI:** 1114734183 (Entity type: Organization)
- **Enumerated:** December 13, 2024
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Lisa King, ADMINISTRATOR
## Practice location
- **Address:** 107 W 19TH ST, Panama City, FL 32405-4647
- **Phone:** (850) 527-6489
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 13, 2024
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1114734183) · Data from the CMS NPPES public registry.