1. Home
  2. Directory
  3. Florida
  4. Destin
  5. Pediatrics
  6. NPI Profile

COASTAL PEDIATRIC GROUP
NPI 1417304643
Pediatrics in Destin, FL

Active since May 17, 2016CLIA 10D2117192 · Waiver
36468 EMERALD COAST PKWY UNIT 2101, DESTIN, FL 32541(850) 659-6556(850) 249-1308 Get Directions Write a Review

NPPES record last updated: January 2, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 2, 2019, May 17, 2016 (2 updates tracked since 2016).

About Coastal Pediatric Group NPPES

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

COASTAL PEDIATRIC GROUP (NPI 1417304643) is a healthcare organization registered as a pediatrics in Destin, Florida and active in the NPI registry since May 2016. The organization holds a CLIA Waiver certificate valid through August 9, 2026 and lists Marilyn T Sprenkle, Owner, as its authorized official.

NPPES Registry Identity

NPI1417304643
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameCOASTAL PEDIATRIC GROUP
Location Address36468 EMERALD COAST PKWY UNIT 2101Destin, FL 32541
Mailing Address36468 Emerald Coast Pkwy Unit 2101Destin, FL 32541 · (850) 659-6556 · Fax (850) 249-1308
Phone(850) 659-6556
Fax(850) 249-1308
Organization SubpartNo
Authorized OfficialMarilyn T SprenkleOwner · (850) 659-6556
Enumeration DateMay 17, 2016
Last NPPES UpdateJanuary 2, 20192 updates tracked since enumeration
✔ NPI 1417304643 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in FL · ME87333
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
36468 EMERALD COAST PKWY UNIT 2101, Destin, FL 32541
Open in Google Maps ↗

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2117192

Coastal Pediatric Group, LLC · Santa Rosa Beach, FL
Active · expires Aug 9, 2026
CLIA Number10D2117192
Laboratory TypePhysician Office
Certificate Effective DateAugust 10, 2024
Certificate Expiration DateAugust 9, 2026
Laboratory DirectorSusanna Buchholz
Laboratory Phone(850) 659-6556
Laboratory LocationCoastal Pediatric Group, LLC91 Mack Bayou Loop, Santa Rosa Beach, FL 32459
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Coastal Pediatric Group's NPI number?

The NPI number for Coastal Pediatric Group is 1417304643. It was assigned to this organization in the NPPES registry on May 17, 2016.

Where is Coastal Pediatric Group located?

Coastal Pediatric Group is located at 36468 Emerald Coast Pkwy Unit 2101, Destin, FL 32541. The listed phone number is (850) 659-6556.

What is Coastal Pediatric Group's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Coastal Pediatric Group hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2117192) is associated with this NPI, valid through August 9, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Coastal Pediatric Group accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Coastal Pediatric Group as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Coastal Pediatric Group was last updated on January 2, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.