Active NPI
Emerald Coast Rehabilitation Center, LLC
- Skilled Nursing Facility
- Fort Walton Beach, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- SNF11410961
- Legal business name
- EMERALD COAST REHABILITATION CENTER, LLC
- Practice address
- 114 3Rd St SE
Fort Walton Beach, FL 32548-5401 - Phone
- (850) 243-6134
- Fax
- (850) 243-9759
- NPI assigned
- Jun 9, 2005
- Organization subpart
- Yes
- Parent organization
- HEARTHSTONE SENIOR COMMUNITIES, INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Howard Jaffe
- Title
- President
- Phone
- (215) 346-6454
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | SNF11410961 | FL | Primary |
Addresses
Primary practice location
114 3Rd St SE
Fort Walton Beach, FL 32548-5401
Mailing address
1665 Palm Beach Lakes Blvd Ste 400
West Palm Beach, FL 33401-2108
Phone (561) 223-4300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 013319600 | Medicaid | FL |
Other names 1
- Emerald Coast Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140603000532 | FL | Part A Provider - Skilled Nursing Facility | 4981827391 | Practice locations: Fort Walton Beach, FL |
Skilled nursing facility certification: CCN 105265
- Legal name
- EMERALD COAST REHABILITATION CENTER LLC
- Doing business as
- EMERALD COAST CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Aug 7, 1973
- Last certification
- Jul 18, 2024
- Beds
- 120
- Ownership / control type
- Individual
- Organization structure
- LLC
- Incorporated
- Sep 18, 2008 in FL
- Enrollment address
- 114 3Rd Street South East
Fort Walton Beach, FL 32548-5497 - Nursing home name
- EMERALD COAST CENTER
- Affiliated entity
- HEARTHSTONE SENIOR COMMUNITIES
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Emerald Coast Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Individual
- Certified
- Aug 7, 1973
- Medicare certification status
- Active
- Certified beds
- 120
- Chain
- Hearthstone Senior Communities
- Penalties (3 years)
- 2
National Provider Directory
National Provider Directory- Part of
- Hearthstone Senior Communities Inc
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Ownership & related parties
All disclosed owners & managing parties 13
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Hearthstone Senior Communities, Inc. | 5% Or Greater Indirect Ownership Interest | Apr 1, 2009 | 100% |
| Adp of the SNF | Apr 8, 2025 | ||
| Alvin Garner | Corporate Officer | Apr 1, 2009 | |
| Omega Healthcare Investors, Inc. | Adp of the SNF | Aug 1, 2003 | |
| Lori Rombold | Corporate Officer | Apr 1, 2009 | |
| Howard Jaffe | Corporate Officer | Apr 1, 2009 | |
| Sherri McKay | Operational/Managerial Control | Apr 1, 2009 | |
| Adp of the SNF | Apr 1, 2009 | ||
| Themis Health Management, LLC | Operational/Managerial Control | Sep 1, 2009 | |
| Adp of the SNF | Apr 8, 2025 | ||
| Tammy Hardy-Fauber | Operational/Managerial Control | Apr 27, 2021 | |
| Adp of the SNF | Apr 27, 2021 | ||
| Consulting Support Services, LLC | Operational/Managerial Control | Jun 28, 2011 | |
| Adp of the SNF | Apr 8, 2025 | ||
| Facility Support Company, LLC | Operational/Managerial Control | Dec 13, 2010 | |
| Adp of the SNF | Mar 19, 2025 | ||
| Kane Financial Services, LLC | Operational/Managerial Control | Jun 6, 2012 | |
| Adp of the SNF | Mar 19, 2025 | ||
| Select Rehabilitation, LLC | Adp of the SNF | Aug 19, 2016 | |
| Brian Wyatt | Corporate Officer | Apr 1, 2009 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
Facilities with the same owner 36
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Bartow, FL
- NPI 1215938444
Consulting Support Services, LLC, Facility Support Company, LLC, Hearthstone Senior Communities, Inc., Kane Financial Services, LLC, Themis Health Management, LLC
-
- Skilled Nursing Facility
- Gulfport, FL
- NPI 1720082688
Consulting Support Services, LLC, Facility Support Company, LLC, Hearthstone Senior Communities, Inc., Kane Financial Services, LLC, Themis Health Management, LLC
-
- Skilled Nursing Facility
- Clearwater, FL
- NPI 1790789675
Consulting Support Services, LLC, Facility Support Company, LLC, Hearthstone Senior Communities, Inc., Kane Financial Services, LLC, Themis Health Management, LLC
-
- Skilled Nursing Facility
- Saint Petersburg, FL
- NPI 1851395677
Consulting Support Services, LLC, Facility Support Company, LLC, Hearthstone Senior Communities, Inc., Kane Financial Services, LLC, Themis Health Management, LLC
-
- Skilled Nursing Facility
- St Petersburg, FL
- NPI 1346244084
Consulting Support Services, LLC, Facility Support Company, LLC, Kane Financial Services, LLC
-
- Skilled Nursing Facility
- Boca Raton, FL
- NPI 1033113774
Consulting Support Services, LLC, Facility Support Company, LLC, Kane Financial Services, LLC
-
- Skilled Nursing Facility
- Pompano Beach, FL
- NPI 1285638924
Consulting Support Services, LLC, Facility Support Company, LLC, Kane Financial Services, LLC
-
- Skilled Nursing Facility
- Cape Coral, FL
- NPI 1528062270
Consulting Support Services, LLC, Facility Support Company, LLC, Kane Financial Services, LLC
-
- Skilled Nursing Facility
- Tampa, FL
- NPI 1447254107
Consulting Support Services, LLC, Facility Support Company, LLC, Kane Financial Services, LLC
-
- Skilled Nursing Facility
- Bradenton, FL
- NPI 1942204607
Consulting Support Services, LLC, Facility Support Company, LLC, Kane Financial Services, LLC
-
- Skilled Nursing Facility
- Spring Hill, FL
- NPI 1487658043
Consulting Support Services, LLC, Facility Support Company, LLC, Kane Financial Services, LLC
-
- Skilled Nursing Facility
- Clearwater, FL
- NPI 1366446924
Consulting Support Services, LLC, Facility Support Company, LLC, Kane Financial Services, LLC, Themis Health Management, LLC
Practitioners & affiliated clinicians
Affiliated clinicians 2
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Internal Medicine Physician
- Fort Walton Beach, FL
- NPI 1942285036
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118275200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1742169600000",
"number": "1891799623",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1665 PALM BEACH LAKES BLVD STE 400",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334012108",
"telephone_number": "561-223-4300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "114 3RD ST SE",
"city": "FORT WALTON BEACH",
"state": "FL",
"postal_code": "325485401",
"telephone_number": "850-243-6134",
"fax_number": "850-243-9759"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EMERALD COAST REHABILITATION CENTER, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "HEARTHSTONE SENIOR COMMUNITIES, INC",
"enumeration_date": "2005-06-09",
"last_updated": "2025-03-17",
"certification_date": "2025-03-17",
"status": "A",
"authorized_official_last_name": "JAFFE",
"authorized_official_first_name": "HOWARD",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "215-346-6454"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "FL",
"license": "SNF11410961",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "013319600",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Emerald Coast Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Fort Walton Beach, FL
- Emerald Coast Mood & Memory PA
- Emerald Coast Oncology and Hematology Assoc., P.a.
- Emerald Coast Pathology Associates PA
- Emerald Coast Personal Care
- Emerald Coast Psychotherapy, LLC
- Emerald Coast Speech Therapy LLC
- Emerald Coast Sports Medicine and Orthopaedics, P.a.
- Emerald Coast Support Coordinators, Inc.
- Emerald Coast Surgery Center, LP
- Emerald Coast TMS of Fort Walton Beach
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- 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.