NPIMap

Organization Active NPI

Orthopaedic Associates PA

  • Orthopaedic Surgery Physician
  • Destin, FL
National Provider Identifier
1124155783
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
ORTHOPAEDIC ASSOCIATES PA
Practice address
36474 Emerald Coast Parkway
Building C Suite 3101
Destin, FL 32541-4713
Phone
(508) 632-1538
Fax
(850) 315-9350
NPI assigned
Feb 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2023

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

Authorized official

Name
Angela Archie
Title
Billing Manager
Phone
(850) 863-2153

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

36474 Emerald Coast Parkway
Building C Suite 3101
Destin, FL 32541-4713

Mailing address

PO Box 740923
Atlanta, GA 30374-0923
Phone (850) 863-2153

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930031875 FL DME Supplier - Physician - Orthopedic/Orthopedic Surgery 5294823084 Practice locations: Destin, FL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

36474 Emerald Coast Pkwy
#3202C
Destin, FL 32541

36474 Emerald Coast Pkwy
#3101
Destin, FL 32541

36474C Emerald Coast Pkwy
Ste 3101
Destin, FL 32541
Phone (850) 344-1646

36474 Emerald Coast Pkwy
#C3101
Destin, FL 32541
Phone (508) 632-1538

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691971200000",
    "number": "1124155783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 740923",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303740923",
            "telephone_number": "850-863-2153",
            "fax_number": "850-315-9350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36474 EMERALD COAST PARKWAY",
            "address_2": "BUILDING C SUITE 3101",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325414713",
            "telephone_number": "508-632-1538",
            "fax_number": "850-315-9350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPAEDIC ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A",
        "authorized_official_last_name": "ARCHIE",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "850-863-2153"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Destin, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; 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.