NPIMap

Organization Active NPI

Destin Senior Care, LLC

  • Skilled Nursing Facility
  • Destin, FL
National Provider Identifier
1487364204
Registry record updated Dec 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
DESTIN SENIOR CARE, LLC
Practice address
195 Mattie Kelly Blvd
Destin, FL 32541-2811
Phone
(317) 514-5985
NPI assigned
Dec 2, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2022

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

Authorized official

Name
Taylor Huston, ESQ.
Title
General Counsel
Phone
(317) 514-5985

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

195 Mattie Kelly Blvd
Destin, FL 32541-2811

Mailing address

421 N Macarthur Ave
Panama City, FL 32401-3767

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230705001479 FL Part A Provider - Skilled Nursing Facility 8527427814 Practice locations: Destin, FL

Skilled nursing facility certification: CCN 106152

Legal name
DESTIN SENIOR CARE, LLC
Doing business as
DESTINATION HEALTH AND REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF (Medicare) only
Participating since
Nov 30, 2023
Last certification
Feb 27, 2025
Beds
119
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
Dec 20, 2022 in DE
Enrollment address
195 Mattie M Kelly Blvd
Destin, FL 32541-2811
Nursing home name
DESTINATION HEALTH AND REHABILITATION CENTER

Care Compare: Nursing home

Medicare Care Compare
Listed as
Destination Health and Rehabilitation CenterCCN 106152
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare
Ownership
For profit - Limited Liability company
Certified
Nov 30, 2023
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
11982.7 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0889348Destination Health and Rehabilitation Center195 Mattie M Kelly Blvd, Destin, FL 32541Certificate of waiverJul 25, 2028

National Provider Directory

National Provider Directory

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Maximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Ownership & related parties

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Organization, Hunt Valley, MD LLC, Real estate investment trust (REIT) Adp of the SNF Apr 17, 2023
Jeffrey Cleveland Individual Managing Control - Governing Body Apr 17, 2023
Geoffrey Fraser Individual Corporate Officer Apr 17, 2023 30%
Managing Control - Governing Body Apr 17, 2023
Brent Hazen Individual Operational/Managerial Control Jun 1, 2024
Adp of the SNF Jul 11, 2025
Destin Senior Investments I LLC Organization, Palm Shores, FL Created for acquisition, LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Dec 20, 2022 30%
Adp of the SNF Apr 17, 2023
Destin Senior Investments II LLC Organization, Palm Shores, FL Created for acquisition, LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Dec 20, 2022 30%
Adp of the SNF Apr 17, 2023
Duane Gallagher Individual Managing Control - Governing Body Apr 17, 2023
Taylor Huston Individual Operational/Managerial Control Apr 17, 2023
Coastal Care Properties LLC Organization, Panama City, FL Created for acquisition, LLC, Holding company 5% Or Greater Direct Ownership Interest Dec 20, 2022 10%
Adp of the SNF Apr 17, 2023
Okaloosa Senior Investments LLC Organization, Freeport, FL Created for acquisition, LLC, Holding company, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Dec 20, 2022 30%
Adp of the SNF Apr 17, 2023
Emily Hittinger Individual Operational/Managerial Control Dec 9, 2024
Adp of the SNF Jul 11, 2025

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 1

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

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1669939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669939200000",
    "number": "1487364204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 N MACARTHUR AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324013767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 MATTIE KELLY BLVD",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325412811",
            "telephone_number": "317-514-5985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESTIN SENIOR CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-02",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A",
        "authorized_official_last_name": "HUSTON",
        "authorized_official_first_name": "TAYLOR",
        "authorized_official_title_or_position": "GENERAL COUNSEL",
        "authorized_official_telephone_number": "317-514-5985",
        "authorized_official_credential": "ESQ."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Destin, FL

Sources for this page

Verify at the official NPI Registry.