NPIMap

Organization Active NPI

Emerald Coast Infectious Diseases Medical Group, P.a.

Doing business as Bay Foot and Ankle Center

  • Durable Medical Equipment & Medical Supplies
  • Fort Walton Beach, FL
National Provider Identifier
1639978356
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.
Doing business as
Bay Foot and Ankle Center
Practice address
1326 Lewis Turner Blvd
Fort Walton Beach, FL 32547-1139
Phone
(850) 855-4048
NPI assigned
Mar 13, 2025
Last updated
Mar 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Authorized official

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

Specialties & licenses 2

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

Addresses

Primary practice location

1326 Lewis Turner Blvd
Fort Walton Beach, FL 32547-1139

Mailing address

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

Other names 1

  • Bay Foot and Ankle Center Doing business as

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.

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.

NPI Registry JSON

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

{
    "created_epoch": "1741824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741824000000",
    "number": "1639978356",
    "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": "1326 LEWIS TURNER BLVD",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325471139",
            "telephone_number": "850-855-4048"
        }
    ],
    "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": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bay Foot and Ankle Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Walton Beach, 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.