Active NPI
Emerald Waters Primary Care P.L.L.C.
- Internal Medicine Physician
- Navarre, FL
National Provider Identifier
1548924350
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- EMERALD WATERS PRIMARY CARE P.L.L.C.
- Practice address
- 7295 Navarre Pkwy
Navarre, FL 32566-7307 - Phone
- (850) 898-0149
- NPI assigned
- Oct 27, 2021
- Last updated
- Sep 7, 2023
- 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
- Wendy Mulky
- Title
- Manager
- Phone
- (850) 341-0648
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary | ||
| Pediatrics Physician | 208000000X |
Addresses
Primary practice location
7295 Navarre Pkwy
Navarre, FL 32566-7307
Mailing address
7295 Navarre Pkwy
Navarre, FL 32566-7307
Phone (850) 898-0149
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
7295 Navarre Pkwy
Navarre, FL 32566
Phone (850) 686-6163
Interoperability endpoints
- https://api.platform.athenahealth.com/24579/brand/1/csg/1/fhir/r4
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Internal Medicine Physician
- Navarre, FL
- NPI 1578670980
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635292800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1694044800000",
"number": "1548924350",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7295 NAVARRE PKWY",
"city": "NAVARRE",
"state": "FL",
"postal_code": "325667307",
"telephone_number": "850-898-0149"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7295 NAVARRE PKWY",
"city": "NAVARRE",
"state": "FL",
"postal_code": "325667307",
"telephone_number": "850-898-0149"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EMERALD WATERS PRIMARY CARE P.L.L.C.",
"organizational_subpart": "NO",
"enumeration_date": "2021-10-27",
"last_updated": "2023-09-07",
"certification_date": "2022-10-13",
"status": "A",
"authorized_official_last_name": "MULKY",
"authorized_official_first_name": "WENDY",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "850-341-0648"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Navarre, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.