NPIMap

Organization Active NPI

Fort Walton Beach Medical Center, Inc.

  • Emergency Care Clinic/Center
  • Destin, FL
National Provider Identifier
1629918347
Registry record updated Mar 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Care Clinic/CenterTaxonomy code 261QE0002X
Legal business name
FORT WALTON BEACH MEDICAL CENTER, INC.
Practice address
200 Tequesta Dr
Destin, FL 32541-4758
Phone
(850) 837-9194
NPI assigned
Mar 31, 2026
Organization subpart
Yes
Parent organization
FORT WALTON BEACH MEDICAL CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 31, 2026

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

Authorized official

Name
Kenneth Donahey II
Title
Ceo
Phone
(850) 862-1111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Care Clinic/Center 261QE0002X Primary

Addresses

Primary practice location

200 Tequesta Dr
Destin, FL 32541-4758

Mailing address

200 Tequesta Dr
Destin, FL 32541-4758
Phone (850) 837-9194

Other names 1

  • HCA Florida Destin Emergency, a department of HCA Florida Fort Walton-Destin Hospital Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0960410HCA Florida Destin Emergency200 Tequesta Drive, Destin, FL 32541AccreditationOct 26, 2026

National Provider Directory

National Provider Directory
Tax ID family
Fort Walton BCH Medical8 organizations share this tax ID, including this one
Part of
Fort Walton BCH Medical

Other organizations with this tax ID 7

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

NPI Registry JSON

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

{
    "created_epoch": "1774915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774915200000",
    "number": "1629918347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 TEQUESTA DR",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325414758",
            "telephone_number": "850-837-9194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 TEQUESTA DR",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325414758",
            "telephone_number": "850-837-9194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT WALTON BEACH MEDICAL CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FORT WALTON BEACH MEDICAL CENTER, INC.",
        "enumeration_date": "2026-03-31",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A",
        "authorized_official_last_name": "DONAHEY",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "850-862-1111",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd Ste B",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "HCA Florida Destin Emergency, a department of HCA Florida Fort Walton-Destin Hospital",
            "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 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.