NPIMap

Organization Active NPI

Fort Walton Beach Medical Center, Inc.

  • General Acute Care Hospital
  • Ft Walton Beach, FL
National Provider Identifier
1104875699
Registry record updated Mar 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
FORT WALTON BEACH MEDICAL CENTER, INC.
Practice address
1000 Mar Walt Dr
Ft Walton Beach, FL 32547-6708
Phone
(850) 862-1111
Fax
(850) 862-9149
NPI assigned
May 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2022

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

Authorized official

Name
Steve Moore
Title
Cfo
Phone
(850) 315-1358

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

1000 Mar Walt Dr
Ft Walton Beach, FL 32547-6708

Mailing address

1000 Mar Walt Dr
Ft Walton Beach, FL 32547-6708
Phone (850) 862-1111

Other identifiers 1

IdentifierTypeStateIssuer
XHSP42482MedicaidCA

Other names 2

  • FORT WALTON BEACH MEDICAL CENTER Doing business as
  • HCA Florida Fort Walton-Destin Hospital Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Fort Walton BCH Medical8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648598400000",
    "number": "1104875699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 MAR WALT DR",
            "city": "FT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476708",
            "telephone_number": "850-862-1111",
            "fax_number": "850-862-9149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MAR WALT DR",
            "city": "FT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476708",
            "telephone_number": "850-862-1111",
            "fax_number": "850-862-9149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT WALTON BEACH MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "850-315-1358"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XHSP42482",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FORT WALTON BEACH MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HCA Florida Fort Walton-Destin Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ft Walton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.