NPIMap

Organization Active NPI

Sandestin Urgent Care, LLC

  • Clinic/Center
  • Miramar Beach, FL
National Provider Identifier
1922341817
Registry record updated Mar 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SANDESTIN URGENT CARE, LLC
Practice address
400 Audubon Dr
Miramar Beach, FL 32550-4594
Phone
(850) 267-6767
NPI assigned
Mar 29, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2014

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

Authorized official

Name
Mr. James Charles Koutsky
Title
Cfo
Phone
(850) 337-5174

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

400 Audubon Dr
Miramar Beach, FL 32550-4594

Mailing address

15000 Emerald Coast Pkwy
Destin, FL 32541-3338
Phone (850) 337-5174

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 5

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1364515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395792000000",
    "number": "1922341817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15000 EMERALD COAST PKWY",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325413338",
            "telephone_number": "850-337-5174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 AUDUBON DR",
            "city": "MIRAMAR BEACH",
            "state": "FL",
            "postal_code": "325504594",
            "telephone_number": "850-267-6767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDESTIN URGENT CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-29",
        "last_updated": "2014-03-26",
        "status": "A",
        "authorized_official_last_name": "KOUTSKY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "850-337-5174",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2014; 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.