Organization Active NPI

Emerald Coast Oncology and Hematology Assoc., P.a.

  • Hematology & Oncology Physician
  • Fort Walton Beach, FL
National Provider Identifier
1861421919
Registry record updated May 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
EMERALD COAST ONCOLOGY AND HEMATOLOGY ASSOC., P.A.
Practice address
1024 Mar Walt Dr
Fort Walton Beach, FL 32547-6645
Phone
(850) 863-3148
NPI assigned
Jul 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2022

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

Authorized official

Name
Cynthia Vinson
Title
Practice Manager
Phone
(850) 863-3148

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RH0003X Primary

Addresses

Primary practice location

1024 Mar Walt Dr
Fort Walton Beach, FL 32547-6645

Mailing address

1024 Mar Walt Dr
Fort Walton Beach, FL 32547-6645
Phone (850) 863-3148

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100322000627 FL Part B Supplier - Clinic/Group Practice 2163557760 Receives reassigned benefits from 9 practitioners
Practice locations: Destin, FL; Fort Walton Beach, FL

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
10D0271526Emerald Coast Oncology and Hematology1024 Mar Walt Dr, Fort Walton Beach, FL 32547ComplianceOct 26, 2026

National Provider Directory

National Provider Directory

Locations

36474 Emerald Coast Pkwy
Ste 1102
Destin, FL 32541
Phone (850) 837-3318

1024 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 863-3132

Practitioners & affiliated clinicians

Practitioners 10

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

NPI Registry JSON

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653264000000",
    "number": "1861421919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1024 MAR WALT DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476645",
            "telephone_number": "850-863-3148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 MAR WALT DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476645",
            "telephone_number": "850-863-3148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERALD COAST ONCOLOGY AND HEMATOLOGY ASSOC., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A",
        "authorized_official_last_name": "VINSON",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "PRACTICE  MANAGER",
        "authorized_official_telephone_number": "850-863-3148"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 May 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.