Emerald Coast Optometry Associates, PA

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

EMERALD COAST OPTOMETRY ASSOCIATES, PA

Practice address

11570 Panama City Beach Pkwy
Ste B
Panama City Beach, FL 32407-2502

Phone

(850) 654-3937

Fax

(850) 654-1070

NPI assigned

Feb 7, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Shannon Dewayne Fowler, O.D.

Title

President

Phone

(850) 654-3937

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1297036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297036800000",
    "number": "1457657561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4418 COMMONS DR E",
            "address_2": "STE A",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325418405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11570 PANAMA CITY BEACH PKWY",
            "address_2": "STE B",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324072502",
            "telephone_number": "850-654-3937",
            "fax_number": "850-654-1070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERALD COAST OPTOMETRY ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-07",
        "last_updated": "2011-02-07",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "DEWAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-654-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Panama City Beach, FL
• Providers in Panama City Beach, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2011; 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.