NPIMap

Organization Active NPI

Emerald Coast Behavioral Hospital, LLC

  • Psychiatric Hospital
  • Panama City, FL
National Provider Identifier
1578795332
Registry record updated Jan 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
License
4500 Issued in FL
Legal business name
EMERALD COAST BEHAVIORAL HOSPITAL, LLC
Practice address
1940 Harrison Avenue
Panama City, FL 32405-4542
Phone
(850) 763-0017
Fax
(850) 532-6462
NPI assigned
Aug 12, 2009
Last updated
Jan 24, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2013

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

Authorized official

Name
Steve Filton
Title
Sr VP & Cfo
Phone
(610) 768-3300

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X
Psychiatric Hospital 283Q00000X 4500 FL Primary
Psychiatry Physician 2084P0800X

Addresses

Primary practice location

1940 Harrison Avenue
Panama City, FL 32405-4542

Mailing address

1940 Harrison Avenue
Panama City, FL 32405-4542
Phone (850) 763-0017

Other identifiers 1

IdentifierTypeStateIssuer
001652300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090825000383 FL Part A Provider - Hospital 3274687363 Practice locations: Panama City, FL
O20100105000568 FL Part B Supplier - Clinic/Group Practice 3274687363 Receives reassigned benefits from 28 practitioners
Practice locations: Panama City, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1578795332. Details of each certification follow.

Hospital certification: CCN 104073

Legal name
EMERALD COAST BEHAVIORAL HOSPITAL LLC
Doing business as
EMERALD COAST BEHAVIORAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Nov 19, 2009
Last certification
Dec 20, 2012
Beds
86
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Incorporated
Aug 11, 2009 in DE
Enrollment address
1940 Harrison Ave
Panama City, FL 32405-4542
Main/Primary Hospital Location
Hospital subgroups
Psychiatric

Care Compare: Hospital

Medicare Care Compare
Listed as
Emerald Coast Behavioral HospitalCCN 104073 · All quality measures
Type
Psychiatric
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory

Locations

2004 Lewis Turner Blvd
Ste B
Fort Walton Beach, FL 32547
Phone (850) 226-7893

2925 Optimist Dr
Marianna, FL 32448
Phone (850) 372-4192

Ownership & related parties

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Premier Behavioral Solutions, Inc. Organization, King of Prussia, PA Corporation, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Aug 11, 2009 100%
George H Brunner Individual Corporate OfficerSecretary Oct 8, 2012 100%
Katharine M Lyver Individual Corporate OfficerAssistant Treasurer Jan 1, 2024 100%
Matthew D Klein Individual Corporate OfficerSecretary- Corporate Nov 15, 2010 100%
Matthew J Peterson Individual Corporate OfficerPresident Sep 19, 2019 100%
Corporate DirectorPresident Sep 19, 2019 33.3%
Operational/Managerial ControlPresident Sep 19, 2019 100%
Thomas M Day Individual Corporate OfficerVice President Jul 20, 2021 100%
Corporate DirectorVice President Jul 20, 2021 33.3%
Steve Filton Individual Corporate OfficerVice President Nov 15, 2010 100%
Corporate DirectorVice President Nov 15, 2010 33.3%
Operational/Managerial ControlVice President Nov 15, 2010 100%
Timothy T Bedford Individual Contracted Managing EmployeeCeo Nov 15, 2010 100%
Corporate OfficerCeo Nov 15, 2010 100%
Cheryl K Ramagano Individual Corporate OfficerTreasurer Nov 15, 2010 100%
Universal Health Services Inc Organization, King of Prussia, PA Corporation, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Nov 15, 2010 100%
Donald Murphy Individual Contracted Managing EmployeeCfo Apr 21, 2025
Corporate OfficerCfo Apr 21, 2025
James M Coleman Individual Contracted Managing Employee Nov 15, 2010
Uhs of Delaware Inc Organization, King of Prussia, PA Corporation, Management services company, Chain home office Operational/Managerial Control Nov 15, 2010 100%
Psychiatric Solutions, Inc. Organization, King of Prussia, PA Corporation, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Aug 11, 2009 100%
Alan B Miller Individual 5% Or Greater Indirect Ownership Interest Nov 15, 2010

Facilities with the same owner 172

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 172

Practitioners & affiliated clinicians

Practitioners 38

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.

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1250035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358985600000",
    "number": "1578795332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 HARRISON AVENUE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054542",
            "telephone_number": "850-763-0017",
            "fax_number": "850-532-6462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 HARRISON AVENUE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054542",
            "telephone_number": "850-763-0017",
            "fax_number": "850-532-6462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERALD COAST BEHAVIORAL HOSPITAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-12",
        "last_updated": "2013-01-24",
        "status": "A",
        "authorized_official_last_name": "FILTON",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "SR VP & CFO",
        "authorized_official_telephone_number": "610-768-3300"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "FL",
            "license": "4500",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001652300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.