Emerald Coast Audiology PA
NPI 1063521698ActiveOrganization· Audiologist· Fort Walton Beach, FL
Audiologist in Fort Walton Beach, Florida, registered in NPPES in August 2006. The authorized official on file is Carver Gray Dethloff, AUD, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1063521698 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 29, 2006 |
| Last updated in NPPES | Jul 21, 2020 |
| Certified by provider | Jul 21, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Audiologist Primary | 231H00000X | AY1018 | FL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (FL) |
|---|
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