Active NPI
Emerald Coast Medical Management PLLC
- Pain Medicine Physician
- Miramar Beach, FL
National Provider Identifier
1497134068
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine Physician
- License
- ME123663
- Legal business name
- EMERALD COAST MEDICAL MANAGEMENT PLLC
- Doing business as
- Emerald Coast Rehabilitation
- Practice address
- 42 Business Centre Dr
Suite 308
Miramar Beach, FL 32550-6920 - Phone
- (850) 460-8778
- Fax
- (850) 460-8779
- NPI assigned
- May 28, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Christopher Lee Nelson, MD
- Title
- Owner
- Phone
- (502) 423-1021
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine Physician | 208VP0000X | ME123663 | FL | Primary |
Addresses
Primary practice location
42 Business Centre Dr
Suite 308
Miramar Beach, FL 32550-6920
Mailing address
42 Business Centre Dr
Suite 308
Miramar Beach, FL 32550-6920
Other names 1
- Emerald Coast Rehabilitation
National Provider Directory
National Provider DirectoryLocations
7720 US Highway 98 W
Ste 300
Destin, FL 32550
Phone (850) 622-9120
42 Business Centre Dr
Unit 308
Miramar Beach, FL 32550
Phone (850) 460-8778
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Physical Medicine & Rehabilitation Physician
- Destin, FL
- NPI 1144295791
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432771200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1433721600000",
"number": "1497134068",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "42 BUSINESS CENTRE DR",
"address_2": "SUITE 308",
"city": "MIRAMAR BEACH",
"state": "FL",
"postal_code": "325506920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "42 BUSINESS CENTRE DR",
"address_2": "SUITE 308",
"city": "MIRAMAR BEACH",
"state": "FL",
"postal_code": "325506920",
"telephone_number": "850-460-8778",
"fax_number": "850-460-8779"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EMERALD COAST MEDICAL MANAGEMENT PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2015-05-28",
"last_updated": "2015-06-08",
"status": "A",
"authorized_official_last_name": "NELSON",
"authorized_official_first_name": "CHRISTOPHER",
"authorized_official_middle_name": "LEE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "502-423-1021",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208VP0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pain Medicine, Pain Medicine",
"state": "FL",
"license": "ME123663",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Emerald Coast Rehabilitation",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Miramar Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.