Emerald Coast Internal Medicine and Geriatrics LLC

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

ME114732 Issued in FL

Legal business name

EMERALD COAST INTERNAL MEDICINE AND GERIATRICS LLC

Practice address

280 Forest Park Cir
Panama City, FL 32405-4919

Phone

(850) 896-9688

Fax

(850) 769-7717

NPI assigned

May 27, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Emad A Eisa, M.D.

Title

Medical Doctor

Phone

(703) 598-6013

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Stephen Wesley Johnson, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Panama City Beach, FL
  • NPI 1679924716
  NPD (past)
• Shimika L Tomes, DPT

  • Physical Therapist
  • Panama City, FL
  • NPI 1538414321
  NPD (past)

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

{
    "created_epoch": "1401148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411516800000",
    "number": "1114339074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 419",
            "city": "LYNN HAVEN",
            "state": "FL",
            "postal_code": "324440419",
            "telephone_number": "850-896-9688",
            "fax_number": "850-769-7717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 FOREST PARK CIR",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054919",
            "telephone_number": "850-896-9688",
            "fax_number": "850-769-7717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERALD COAST INTERNAL MEDICINE AND GERIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-27",
        "last_updated": "2014-09-24",
        "status": "A",
        "authorized_official_last_name": "EISA",
        "authorized_official_first_name": "EMAD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "703-598-6013",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "ME114732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emerald Coast Behavioral Hospital, LLC
• Emerald Coast Eye Care
• Emerald Coast Home Care, Inc.
• Emerald Coast Hospitalist Inc
• Emerald Coast Infectious Diseases Medical Group, P.a.
• Emerald Coast Medical Transport, Inc.
• Emerald Coast OBGYN, Inc
• Emerald Coast Obstetrics & Gynecology, P.a.
• Emerald Coast Orthopedics PLLC
• Emerald Coast Pediatrics & Adolescents

• Geriatric Medicine (Internal Medicine) Physician in Panama City, FL
• Providers in Panama City, FL by specialty
• Geriatric Medicine (Internal Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2014; 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.