Emerald ENT Allergy Hearing and Facial Plastics LLC

Primary specialty

Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X

Legal business name

EMERALD ENT ALLERGY HEARING AND FACIAL PLASTICS LLC

Practice address

141 Mack Bayou Loop Ste 102
Santa Rosa Beach, FL 32459-7194

Phone

(850) 797-6191

Fax

(850) 420-8342

NPI assigned

Sep 1, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Ryan Edgar Gegg, DONPI 1710241054

Title

Owner/Physician

Phone

(810) 610-3313

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ryan Gegg, D.O.

  • Otolaryngology/Facial Plastic Surgery Physician
  • Santa Rosa Beach, FL
  • NPI 1710241054

  Allergy & Immunology

  Medicare reassignment NPD Authorized official
• Joseph Andrew Carter, AUD

  • Audiologist-Hearing Aid Fitter
  • Mobile, AL
  • NPI 1265985121

  FL

  Medicare reassignment NPD

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

{
    "created_epoch": "1630454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658880000000",
    "number": "1003584475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 MACK BAYOU LOOP STE 102",
            "city": "SANTA ROSA BEACH",
            "state": "FL",
            "postal_code": "324597194",
            "telephone_number": "850-797-6191",
            "fax_number": "850-797-6191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 MACK BAYOU LOOP STE 102",
            "city": "SANTA ROSA BEACH",
            "state": "FL",
            "postal_code": "324597194",
            "telephone_number": "850-797-6191",
            "fax_number": "850-420-8342"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "141 Mack Bayou Loop Ste 102",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa Beach",
            "state": "FL",
            "postal_code": "324597194",
            "country_code": "US",
            "telephone_number": "334-793-6673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EMERALD ENT ALLERGY HEARING AND FACIAL PLASTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-01",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A",
        "authorized_official_last_name": "GEGG",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "EDGAR",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "810-610-3313",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Otolaryngology/Facial Plastic Surgery Physician in Santa Rosa Beach, FL
• Providers in Santa Rosa Beach, FL by specialty
• Otolaryngology/Facial Plastic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.