Organization Active NPI

Emerald Coast Medical Management PLLC

  • Pain Medicine Physician
  • Miramar Beach, FL
National Provider Identifier
1497134068
Registry record updated Jun 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
ME123663 Issued in FL
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

Updated by the provider on Jun 8, 2015

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)CodeLicenseStatePrimary
Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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 Doing business as

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.