NPIMap

Organization Active NPI

Emerald Coast Radiation Oncology

  • Radiation Oncology Physician
  • Destin, FL
National Provider Identifier
1891763108
Registry record updated Feb 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
EMERALD COAST RADIATION ONCOLOGY
Practice address
7720 US Highway 98 W.
Suite 140
Destin, FL 32550-7230
Phone
(850) 622-0873
Fax
(850) 622-1912
NPI assigned
Mar 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2010

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

Authorized official

Name
Mr. Buddy Elmore, CFO
Title
Cfo/Secretary/Treasurer
Phone
(850) 416-7638

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0001X Primary

Addresses

Primary practice location

7720 US Highway 98 W.
Suite 140
Destin, FL 32550-7230

Mailing address

PO Box 18490
Pensacola, FL 32523-8490
Phone (850) 622-0873

Other identifiers 2

IdentifierTypeStateIssuer
267422000MedicaidFL
267422000-GROUPMedicaidFL

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 5

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": "1141948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265328000000",
    "number": "1891763108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18490",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325238490",
            "telephone_number": "850-622-0873",
            "fax_number": "850-622-1912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7720 US HIGHWAY 98 W.",
            "address_2": "SUITE 140",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325507230",
            "telephone_number": "850-622-0873",
            "fax_number": "850-622-1912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERALD COAST RADIATION ONCOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-10",
        "last_updated": "2010-02-05",
        "status": "A",
        "authorized_official_last_name": "ELMORE",
        "authorized_official_first_name": "BUDDY",
        "authorized_official_title_or_position": "CFO/SECRETARY/TREASURER",
        "authorized_official_telephone_number": "850-416-7638",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "267422000",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "267422000-GROUP",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Destin, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2010; 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.