NPIMap

Organization Active NPI

Coastal Horizons Center, Inc

  • Community/Behavioral Health Agency
  • Wilmington, NC
National Provider Identifier
1033420153
Registry record updated Jul 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
MHL-065-011 Issued in NC
Legal business name
COASTAL HORIZONS CENTER, INC
Practice address
615 Shipyard Blvd
Wilmington, NC 28412
Phone
(910) 343-0145
Fax
(910) 341-5779
NPI assigned
Jun 23, 2010
Organization subpart
Yes
Parent organization
COASTAL HORIZONS CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 1, 2020

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

Authorized official

Name
Ms. Margaret Weller-Stargell
Title
President/Ceo
Phone
(910) 343-0145

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 6005343 NC
Case Management Agency 251B00000X
Community/Behavioral Health Agency 251S00000X MHL-065-011 NC Primary
Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X MHL-065-011 NC

Addresses

Primary practice location

615 Shipyard Blvd
Wilmington, NC 28412

Mailing address

615 Shipyard Blvd
Wilmington, NC 28412-6431
Phone (910) 343-0145

Other practice location 1

120 Coastal Horizons Dr
Shallotte, NC 28470-6094
Phone (910) 754-4515

Other identifiers 1

IdentifierTypeStateIssuer
3410030MedicaidNC

Other names 1

  • Coastal Horizons Center, Inc CABHA Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080429000046 NC Part B Supplier - Clinic/Group Practice 9739267964 Receives reassigned benefits from 89 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Burgaw, NC; Rocky Point, NC; Shallotte, NC; Wilmington, NC

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Coastal Car

Locations

613 Shipyard Blvd
Ste 104
Wilmington, NC 28412

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1277251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593561600000",
    "number": "1033420153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 SHIPYARD BLVD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284126431",
            "telephone_number": "910-343-0145",
            "fax_number": "910-341-5779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 SHIPYARD BLVD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "28412",
            "telephone_number": "910-343-0145",
            "fax_number": "910-341-5779"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 Coastal Horizons Dr",
            "address_purpose": "LOCATION",
            "city": "Shallotte",
            "state": "NC",
            "postal_code": "284706094",
            "country_code": "US",
            "telephone_number": "910-754-4515",
            "fax_number": "910-754-7997",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COASTAL HORIZONS CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COASTAL HORIZONS CENTER, INC.",
        "enumeration_date": "2010-06-23",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A",
        "authorized_official_last_name": "WELLER-STARGELL",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "910-343-0145",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "6005343",
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "MHL-065-011",
            "primary": true
        },
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "NC",
            "license": "MHL-065-011",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3410030",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Horizons Center, Inc CABHA",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Coastal Horizons Center, Inc CABHA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.