Emerald Coast Pediatrics, P.a.

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME87749 Issued in FL

Legal business name

EMERALD COAST PEDIATRICS, P.A.

Practice address

4860 Woodbine Rd
Suite 1 & 2
Pace, FL 32571-8709

Phone

(850) 995-8087

Fax

(850) 994-5292

NPI assigned

Jun 4, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Shari White

Title

Office Manager

Phone

(850) 623-5437

Specialties & licenses 1

Addresses

Tax ID family

Emerald Coast Pediatrics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Emerald Coast Pediatrics P.a.

  • Pediatrics Physician
  • Milton, FL
  • NPI 1427144153
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David A Hensley, MD

  • Pediatrics Physician
  • Pace, FL
  • NPI 1164417275
  NPD (past)
• Laura Rae Demeter Morette, A.R.N.P.

  • Pediatric Nurse Practitioner
  • Pace, FL
  • NPI 1790938322
  NPD (past)

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801098504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5834 BERRYHILL RD",
            "city": "MILTON",
            "state": "FL",
            "postal_code": "325708275",
            "telephone_number": "850-995-8087",
            "fax_number": "850-994-5292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4860 WOODBINE RD",
            "address_2": "SUITE 1 & 2",
            "city": "PACE",
            "state": "FL",
            "postal_code": "325718709",
            "telephone_number": "850-995-8087",
            "fax_number": "850-994-5292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERALD COAST PEDIATRICS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "SHARI",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "850-623-5437",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME87749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julisa Edwards, MSW, CBHCM
• Kaci Edwards
• Mark Edwards, MD
• Amy Carol Ellis, L.M.H.C.
• Nikki Leigh Ellis, M.S. CCC-SLP
• David Ertle
• Escambia Community Clinics Inc (Hwy 90 Pediatrics)
• Eternal Sole Foot and Ankle LLC
• April M Evans, APRN
• Crystal Lee Evans, ATC/L

• Specialist in Pace, FL
• Providers in Pace, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.