NPIMap

Organization Active NPI

Coastal Home Health & Hospice Inc

Doing business as Coastal Rehabilitation & Wellness

  • Physical Therapist
  • Brookings, OR
National Provider Identifier
1043375520
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3984 Issued in OR
Legal business name
COASTAL HOME HEALTH & HOSPICE INC
Doing business as
Coastal Rehabilitation & Wellness
Practice address
580 5TH St
Suite 600
Brookings, OR 97415-8329
Phone
(541) 469-7314
Fax
(541) 469-3669
NPI assigned
Dec 26, 2006
Last updated
Aug 14, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
COASTAL HOME HEALTH & HOSPICE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

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

Authorized official

Name
Jamie Daugherty, RN
Title
Ceo
Phone
(541) 842-0272

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 3984 OR Primary

Addresses

Primary practice location

580 5TH St
Suite 600
Brookings, OR 97415-8329

Mailing address

580 5TH St
Suite 600
Brookings, OR 97415-8329
Phone (541) 469-7314

Other names 1

  • Coastal Rehabilitation & Wellness Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251017004052 OR Part B Supplier - Clinic/Group Practice 7315115854 Receives reassigned benefits from 6 practitioners
Practice locations: Brookings, OR

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Coastal Home Health Hospice Inc5 organizations share this tax ID, including this one
Part of
Coastal Home Health Hospice Inc

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

38 Oak St
Ste 2
Patchogue, NY 11772
Phone (631) 576-4499

580 5th St
Ste 600
Brookings, OR 97415
Phone (541) 469-7314

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Coastal Home Health & HospiceCrescent City, CA, CCN B51786 Hospice 5% Or Greater Direct Ownership Interest (100%) Dec 8, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755129600000",
    "number": "1043375520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 5TH ST",
            "address_2": "SUITE 600",
            "city": "BROOKINGS",
            "state": "OR",
            "postal_code": "974158329",
            "telephone_number": "541-469-7314",
            "fax_number": "541-469-3669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 5TH ST",
            "address_2": "SUITE 600",
            "city": "BROOKINGS",
            "state": "OR",
            "postal_code": "974158329",
            "telephone_number": "541-469-7314",
            "fax_number": "541-469-3669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL HOME HEALTH & HOSPICE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COASTAL HOME HEALTH & HOSPICE INC",
        "enumeration_date": "2006-12-26",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A",
        "authorized_official_last_name": "DAUGHERTY",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "541-842-0272",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "3984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Rehabilitation & Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brookings, OR

Sources for this page

Verify at the official NPI Registry.