EMERALD COAST DIABETES & NUTRITION CENTER
NPI 1700307550
General Practice in Fort Walton Beach, FL

Q: What is Emerald Coast Diabetes & Nutrition Center's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Active since July 02, 2017

115 MIRACLE STRIP PKWY SE UNIT 101, FORT WALTON BEACH, FL 32548(850) 374-7604(850) 792-2545 Get Directions Write a Review

NPPES record last updated: September 13, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 13, 2022, May 9, 2018, Mar 17, 2018 and 1 more (4 updates tracked since 2017).

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About Emerald Coast Diabetes & Nutrition Center NPPES

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

EMERALD COAST DIABETES & NUTRITION CENTER (NPI 1700307550) is a healthcare organization registered as a general practice in Fort Walton Beach, Florida and active in the NPI registry since July 2017. The organization maintains a secondary practice location in Crestview and lists Deanna Howard-gonzalez, Owner, as its authorized official.

NPPES Registry Identity

NPI1700307550

Entity TypeOrganization

Primary Taxonomy208D00000X

Legal Business NameEMERALD COAST DIABETES & NUTRITION CENTER

Location Address115 MIRACLE STRIP PKWY SE UNIT 101Fort Walton Beach, FL 32548-5976

Mailing Address115 Miracle Strip Pkwy Se Unit 101Fort Walton Beach, FL 32548-5976 · (850) 374-7604 · Fax (850) 792-2545

Phone(850) 374-7604

Fax(850) 792-2545

Organization SubpartNo

Authorized OfficialDeanna Howard-gonzalezOwner · (850) 374-7604

Enumeration DateJuly 2, 2017

Last NPPES UpdateSeptember 13, 20224 updates tracked since enumeration

NPPES CertifiedSeptember 13, 2022

✔ NPI 1700307550 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

Also ListedDietitian, RegisteredTaxonomy 133V00000X · License ND3885 (FL)

115 MIRACLE STRIP PKWY SE UNIT 101, Fort Walton Beach, FL 32548

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Secondary Practice Location 1

Location 1951 S Ferdon BlvdCrestview, FL 32536-4507 · Phone (850) 374-7604 · Fax (850) 792-2545

Other Identifiers 2

Other1J0TMFL · Bcbs

OtherND3885FL · Florida License

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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 Diabetes & Nutrition Center 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 Diabetes & Nutrition Center, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Deanna Howard-Gonzalez, RD, LD, CDE

Registered Dietitian or Nutrition Professional

NPI 1881823060

115 MIRACLE STRIP PKWY SE UNIT 101
Fort Walton Beach, FL 32548

(850) 374-7604

✔ Accepts MedicareSame address

Judith Medina, MS, RDN, LD

Registered Dietitian or Nutrition Professional

NPI 1619861952

6000 US-98
Pensacola, FL 32512

(850) 505-6601

✔ Accepts Medicare41 mi

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 Diabetes & Nutrition Center's NPI number?

The NPI number for Emerald Coast Diabetes & Nutrition Center is 1700307550. It was assigned to this organization in the NPPES registry on July 2, 2017.

Where is Emerald Coast Diabetes & Nutrition Center located?

Emerald Coast Diabetes & Nutrition Center is located at 115 Miracle Strip Pkwy SE Unit 101, Fort Walton Beach, FL 32548. The listed phone number is (850) 374-7604.

What is Emerald Coast Diabetes & Nutrition Center's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Emerald Coast Diabetes & Nutrition Center enrolled in Medicare?

Yes. Emerald Coast Diabetes & Nutrition Center is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Emerald Coast Diabetes & Nutrition Center?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Registered Dietitian or Nutrition Professional, reassign their Medicare billing to Emerald Coast Diabetes & Nutrition Center. 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, 1 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 Diabetes & Nutrition Center was last updated on September 13, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.