Spine Institute on the Emerald Coast

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

SPINE INSTITUTE ON THE EMERALD COAST

Doing business as

Coastal Neurosurgery & Spine

Practice address

350G Racetrack Rd NW
Fort Walton Beach, FL 32547-1699

Phone

(850) 460-2350

NPI assigned

Aug 11, 2020

Last updated

Apr 10, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amrish Patel, MD

Title

Chief Medical Officer, Owner

Phone

(706) 580-3607

Specialties & licenses 1

Addresses

Other names 1

• Coastal Neurosurgery & Spine Doing business as

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

{
    "created_epoch": "1597104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712707200000",
    "number": "1184235558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 600366",
            "city": "ST JOHNS",
            "state": "FL",
            "postal_code": "322600366",
            "telephone_number": "904-717-9625",
            "fax_number": "904-683-6499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350G RACETRACK RD NW",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325471699",
            "telephone_number": "850-460-2350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE INSTITUTE ON THE EMERALD COAST",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-11",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "AMRISH",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER, OWNER",
        "authorized_official_telephone_number": "706-580-3607",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Neurosurgery & Spine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Coastal Neurosurgery & Spine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Durable Medical Equipment & Medical Supplies in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; 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.