NPIMap

Organization Active NPI

Fort Walton Beach Medical Center, Inc.

  • Clinic/Center
  • Fort Walton Beach, FL
National Provider Identifier
1194650341
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
FORT WALTON BEACH MEDICAL CENTER, INC.
Practice address
1020 Titan CT Ste 100
Fort Walton Beach, FL 32547-6638
Phone
(850) 315-8009
NPI assigned
Jun 17, 2026
Organization subpart
Yes
Parent organization
FORT WALTON BEACH MEDICAL CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Authorized official

Name
KC Donahey II
Title
Ceo
Phone
(850) 315-8009

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1020 Titan CT Ste 100
Fort Walton Beach, FL 32547-6638

Mailing address

1020 Titan CT Ste 100
Fort Walton Beach, FL 32547-6638
Phone (850) 315-8009

Other names 1

  • Intensive Outpatient Behavioral Health Therapy, a department of HCA Florida Fort Walton-Destin Hospi Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

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.

Locations

1020 Titan Ct
Ste 100
Fort Walton Beach, FL 32547
Phone (850) 315-8009

NPI Registry JSON

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

{
    "created_epoch": "1781654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781654400000",
    "number": "1194650341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 TITAN CT STE 100",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476638",
            "telephone_number": "850-315-8009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 TITAN CT STE 100",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476638",
            "telephone_number": "850-315-8009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT WALTON BEACH MEDICAL CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FORT WALTON BEACH MEDICAL CENTER, INC.",
        "enumeration_date": "2026-06-17",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A",
        "authorized_official_last_name": "DONAHEY",
        "authorized_official_first_name": "KC",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "850-315-8009",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd Ste B",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Intensive Outpatient Behavioral Health Therapy, a department of HCA Florida Fort Walton-Destin Hospi",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Walton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2026; 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.