Emerald Coast Family Medicine Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME97507 Issued in FL

Legal business name

EMERALD COAST FAMILY MEDICINE INC

Practice address

143 S John Sims Pkwy
Valparaiso, FL 32580-1271

Phone

(850) 729-3300

Fax

(850) 729-3100

NPI assigned

May 2, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Deann Marie Castaneda

Title

Office Manager

Phone

(850) 729-3300

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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

• Thaddaeus R Castaneda, M.D.

  • Family Medicine Physician
  • Valparaiso, FL
  • NPI 1710920897
  Medicare reassignment NPD

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1093937963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 S JOHN SIMS PKWY",
            "city": "VALPARAISO",
            "state": "FL",
            "postal_code": "325801271",
            "telephone_number": "850-729-3300",
            "fax_number": "850-729-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 S JOHN SIMS PKWY",
            "city": "VALPARAISO",
            "state": "FL",
            "postal_code": "325801271",
            "telephone_number": "850-729-3300",
            "fax_number": "850-729-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERALD COAST FAMILY MEDICINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "CASTANEDA",
        "authorized_official_first_name": "DEANN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "850-729-3300",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME97507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donald B. Schak Sr., M.D., PA
• Marion Worth Duncan III
• Emerald Coast Autism Center
• Emerald Coast Autism Center
• Emerald Coast Autism Center
• Amarylis Remelle Emrick
• Kathryn Greer Fagan
• Rachael Flint
• Kristin Joy Freeland, SPEECH LANGUAGE PATH
• Summer Fritz, NP

• Family Medicine Physician in Valparaiso, FL
• Providers in Valparaiso, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.