South Walton Medical Center Inc

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

FLME43330 Issued in FL

Legal business name

SOUTH WALTON MEDICAL CENTER INC

Practice address

10005C US Highway 98 W
Destin, FL 32550-4962

Phone

(850) 837-8005

Fax

(850) 837-4352

NPI assigned

Mar 10, 2008

Last updated

Feb 3, 2009By 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

Ronald Bruce Causton, MD

Title

Owner/Physician

Phone

(850) 837-8005

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1205107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233619200000",
    "number": "1659541340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10005C US HIGHWAY 98 W",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325504962",
            "telephone_number": "850-837-8005",
            "fax_number": "850-837-4352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10005C US HIGHWAY 98 W",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325504962",
            "telephone_number": "850-837-8005",
            "fax_number": "850-837-4352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH WALTON MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-10",
        "last_updated": "2009-02-03",
        "status": "A",
        "authorized_official_last_name": "CAUSTON",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "BRUCE",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "850-837-8005",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "FL",
            "license": "FLME43330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "46168",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "265468700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Destin, FL
• Providers in Destin, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2009; 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.