Destin Podiatry, LLC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

PO3084 Issued in FL

Legal business name

DESTIN PODIATRY, LLC

Doing business as

Coastal Foot & Ankle
Coastal Foot and Ankle

Practice address

12216 Panama City Beach Pkwy Ste C
Panama City Beach, FL 32407-2728

Phone

(850) 650-6492

Fax

(850) 650-2178

NPI assigned

Jul 18, 2013

Last updated

Jun 13, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

DESTIN PODIATRY, LLCAs reported in NPPES

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

Authorized official

Name

Dr. Thomas Whitfield Roberts, DPMNPI 1841221181

Title

Owner

Phone

(850) 650-6492

Specialties & licenses 1

Addresses

Other names 2

• Coastal Foot & Ankle Doing business as
• Coastal Foot and Ankle Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Destin Podiatry LLC

  dba Coastal Foot & Ankle

  • Podiatrist
  • Santa Rosa Beach, FL
  • NPI 1427389220

  8426185331

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Destin Podiatry LLC

  dba Coastal Foot & Ankle

  • Podiatrist
  • Santa Rosa Beach, FL
  • NPI 1427389220

  O20131126000270

  Same enrollment

Part of

Destin Podiatry LLC

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Destin Podiatry LLC

  dba Coastal Foot & Ankle

  • Podiatrist
  • Santa Rosa Beach, FL
  • NPI 1427389220
  NPPES parent name

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.

• Thomas Whitfield Roberts, DPM

  • Podiatrist
  • Santa Rosa Beach, FL
  • NPI 1841221181
  NPD Authorized official

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

{
    "created_epoch": "1374105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718236800000",
    "number": "1700228897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2441 US HIGHWAY 98 W STE 102",
            "city": "SANTA ROSA BEACH",
            "state": "FL",
            "postal_code": "324595386",
            "telephone_number": "850-650-6492",
            "fax_number": "850-650-2178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12216 PANAMA CITY BEACH PKWY STE C",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324072728",
            "telephone_number": "850-650-6492",
            "fax_number": "850-650-2178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESTIN PODIATRY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DESTIN PODIATRY, LLC",
        "enumeration_date": "2013-07-18",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "WHITFIELD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-650-6492",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO3084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Foot & Ankle",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Coastal Foot and Ankle",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brenda Lea Dement
• Lauren Dempsey
• Dermatology Associates of Bay County, P.a.
• Dermatology Associates of Bay County, P.a.
• Destin Dental Group
• Anna Deutsch, PA
• Elizabeth Lewis Devine, DPT
• Crystal Marie Diltz, PHARM.D.
• Dixie Allison, LCSW, LLC
• Ashley Donaldson, NP-C

• Podiatrist in Panama City Beach, FL
• Providers in Panama City Beach, FL by specialty
• Podiatrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; 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.