EMERALD COAST AUDIOLOGY PA
NPI 1063521698
Audiologist in Fort Walton Beach, FL

Q: What is Emerald Coast Audiology PA's NPI number?

The NPI number for Emerald Coast Audiology PA is 1063521698. It was assigned to this organization in the NPPES registry on August 29, 2006.

Q: What is Emerald Coast Audiology PA's specialty?

The primary specialty registered for this NPI is Audiologist with taxonomy code 231H00000X.

Active since August 29, 2006

11 RACETRACK RD NE STE E4, FORT WALTON BEACH, FL 32547(850) 315-4141(850) 226-8242 Get Directions Write a Review

NPPES record last updated: July 21, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Emerald Coast Audiology Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EMERALD COAST AUDIOLOGY PA (NPI 1063521698) is a healthcare organization registered as an audiologist in Fort Walton Beach, Florida and active in the NPI registry since August 2006. The organization lists Carver Gray Dethloff, Owner, as its authorized official.

NPPES Registry Identity

NPI1063521698

Entity TypeOrganization

Primary Taxonomy231H00000X

Legal Business NameEMERALD COAST AUDIOLOGY PA

Location Address11 RACETRACK RD NE STE E4Fort Walton Beach, FL 32547-1867

Mailing Address11 Racetrack Rd Ne Ste E4Fort Walton Beach, FL 32547-1867 · (850) 315-4141 · Fax (850) 226-8242

Phone(850) 315-4141

Fax(850) 226-8242

Organization SubpartNo

Authorized OfficialCarver Gray DethloffOwner · (850) 315-4141

Enumeration DateAugust 29, 2006

Last NPPES UpdateJuly 21, 2020

NPPES CertifiedJuly 21, 2020

✔ NPI 1063521698 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAudiologistSpeech, Language and Hearing Service Providers

Taxonomy Code231H00000X

License✔ Licensed in FL · AY1018

Definition

(1) A specialist in evaluation, habilitation and rehabilitation of those whose communication disorders center in whole or in part in hearing function. Audiologists are autonomous professionals who identify, assess, and manage disorders of the auditory, balance and other neural systems. Audiologists provide audiological (aural) rehabilitation to children and adults across the entire age span. Audiologists select, fit and dispense amplification systems such as hearing aids and related devices. (2) An audiologist is a person qualified by a master's degree in audiology, licensed by the state, where applicable, and practicing within the scope of that license. Audiologists evaluate and treat patients with impaired hearing. They plan, direct and conduct rehabilitative programs with audiotry substitutional devises (hearing aids) and other therapy.

11 RACETRACK RD NE STE E4, Fort Walton Beach, FL 32547

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Other Identifiers 2

Medicaid600389300FL

OtherS9298FL · Bcbs

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Emerald Coast Audiology Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 2 clinicians reassign Medicare billing to Emerald Coast Audiology PA, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Kathryn Alba, AU.D.

Qualified Audiologist

NPI 1932517661

11 RACETRACK RD NE STE E4
Fort Walton Beach, FL 32547

(850) 315-4141

✔ Accepts MedicareSame address

Carver Dethloff, AU.D.

Qualified Audiologist

NPI 1194700922

11 RACETRACK RD NE STE E4
Fort Walton Beach, FL 32547

(850) 315-4141

✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Emerald Coast Audiology PA's NPI number?

The NPI number for Emerald Coast Audiology PA is 1063521698. It was assigned to this organization in the NPPES registry on August 29, 2006.

Where is Emerald Coast Audiology PA located?

Emerald Coast Audiology PA is located at 11 Racetrack Rd NE Ste E4, Fort Walton Beach, FL 32547. The listed phone number is (850) 315-4141.

What is Emerald Coast Audiology PA's specialty?

The primary specialty registered for this NPI is Audiologist with taxonomy code 231H00000X.

Is Emerald Coast Audiology PA enrolled in Medicare?

Yes. Emerald Coast Audiology PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Emerald Coast Audiology PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Qualified Audiologist, reassign their Medicare billing to Emerald Coast Audiology PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Emerald Coast Audiology PA was last updated on July 21, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.