Emerald Coast Heart & Afib, PLLC

Primary specialty

Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X

Legal business name

EMERALD COAST HEART & AFIB, PLLC

Practice address

550 Redstone Ave W Ste 430
Crestview, FL 32536-6457

Phone

(850) 602-0094

NPI assigned

Nov 18, 2024

Last updated

Jan 22, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ian Landon Weisberg, MDNPI 1134297385

Title

Owner, Physician

Phone

(850) 854-3278

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 2

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.

• Ian Landon Weisberg, MD

  • Clinical Cardiac Electrophysiology Physician
  • Crestview, FL
  • NPI 1134297385
  Medicare reassignment Care Compare group NPD Authorized official
• Kelly Smidebush, ARNP

  • Nurse Practitioner
  • Crestview, FL
  • NPI 1104176833
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1731888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737504000000",
    "number": "1578388229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 REDSTONE AVE W STE 430",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325366457",
            "telephone_number": "850-854-3278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 REDSTONE AVE W STE 430",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325366457",
            "telephone_number": "850-602-0094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERALD COAST HEART & AFIB, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-18",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A",
        "authorized_official_last_name": "WEISBERG",
        "authorized_official_first_name": "IAN",
        "authorized_official_middle_name": "LANDON",
        "authorized_official_title_or_position": "OWNER, PHYSICIAN",
        "authorized_official_telephone_number": "850-854-3278",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gracie Edge
• Mae Edge
• Elevate Hope
• Nicoline Elkins, MS, ATC, LAT, CEP
• Emerald Coast Dermatology & Skin Surgery Center PA
• Emerald Coast Infectious Diseases Medical Group, P.a.
• Emerald Coast Pulmonology, PA
• Emerald Coast Urology, LLC
• Emerald Coast Women's Center, P.L.
• Empowering Minds

• Clinical Cardiac Electrophysiology Physician in Crestview, FL
• Providers in Crestview, FL by specialty
• Clinical Cardiac Electrophysiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; 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.

Verify at the official NPI Registry.