Organization Active NPI

Emerald Coast Infectious Diseases Medical Group, P.a.

  • Durable Medical Equipment & Medical Supplies
  • Destin, FL
National Provider Identifier
1548069263
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
EMERALD COAST INFECTIOUS DISEASES MEDICAL GROUP, P.A.
Practice address
137 Crystal Beach Dr Ste 121
Destin, FL 32541-3573
Phone
(850) 807-4388
NPI assigned
Mar 13, 2025
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Kelley Gear
Title
Assistant Practice Manager
Phone
(850) 862-3979

Practitioners 1

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

National Provider Directory

National Provider Directory
Tax ID family
Emerald Coast Infectious Diseases Medical Group PA7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary
Customized Equipment (DME) 332BC3200X

Addresses

NPPES NPI Registry

Primary practice location

137 Crystal Beach Dr Ste 121
Destin, FL 32541-3573

Mailing address

917 Mar Walt Dr
Fort Walton Beach, FL 32547-6651
Phone (850) 862-3979

Other names 1

NPPES NPI Registry
  • American Medical Group Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 13, 2025.

{
    "created_epoch": "1741824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741824000000",
    "number": "1548069263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 MAR WALT DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476651",
            "telephone_number": "850-862-3979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 CRYSTAL BEACH DR STE 121",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325413573",
            "telephone_number": "850-807-4388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERALD COAST INFECTIOUS DISEASES MEDICAL GROUP, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-13",
        "last_updated": "2025-03-13",
        "certification_date": "2025-02-27",
        "status": "A",
        "authorized_official_last_name": "GEAR",
        "authorized_official_first_name": "KELLEY",
        "authorized_official_title_or_position": "ASSISTANT PRACTICE MANAGER",
        "authorized_official_telephone_number": "850-862-3979"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "American Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Destin, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2025; 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.