Walton County Citizens Advisory Council on Aging, Inc.

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

WALTON COUNTY CITIZENS ADVISORY COUNCIL ON AGING, INC.

Doing business as

Walton Okaloosa Council on Aging

Practice address

1154 Baldwin Ave
Defuniak Springs, FL 32435-2308

Phone

(850) 892-8165

Fax

(850) 892-8169

NPI assigned

Mar 22, 2007

Last updated

Jan 12, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Shayne Betts

Title

Executive Director

Phone

(859) 892-8165

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Walton Okaloosa Council on Aging Doing business as

Locations

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673481600000",
    "number": "1982720769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1154 BALDWIN AVE",
            "city": "DEFUNIAK SPRINGS",
            "state": "FL",
            "postal_code": "324352308",
            "telephone_number": "850-892-8165",
            "fax_number": "850-892-8169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1154 BALDWIN AVE",
            "city": "DEFUNIAK SPRINGS",
            "state": "FL",
            "postal_code": "324352308",
            "telephone_number": "850-892-8165",
            "fax_number": "850-892-8169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALTON COUNTY CITIZENS ADVISORY COUNCIL ON AGING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A",
        "authorized_official_last_name": "BETTS",
        "authorized_official_first_name": "SHAYNE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "859-892-8165",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024864900",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "677320600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walton Okaloosa Council on Aging",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Walton Okaloosa Council on Aging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kimberly L Wagner, RBT
• Wal-Mart Stores East LP (Walmart Pharmacy 10-1134)
• Wal-Mart Stores East, LP (Vision Center 30-1134)
• Walgreen Co (Walgreens #09914)
• Timothy W Walker, MD
• Walton County Convalescent Center Operations, L.L.C. (Chautauqua Rehabilitation and Nursing Center)
• Walton County Healh Department
• Walton County Health Department
• Walton County Health Department
• Walton County Health Department

• Case Management Agency in Defuniak Springs, FL
• Providers in Defuniak Springs, FL by specialty
• Case Management Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2023; 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.