Coastal Enterprises of Wilmington

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

COASTAL ENTERPRISES OF WILMINGTON

Practice address

1214 Kidder St
Wilmington, NC 28401-5918

Phone

(910) 763-3424

Fax

(910) 815-0367

NPI assigned

Feb 13, 2007

Last updated

Mar 7, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Donald Leon Hoover, BS, QP

Title

Idd Services Coordinator

Phone

(910) 763-3424

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551916800000",
    "number": "1053453258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1214 KIDDER ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284015918",
            "telephone_number": "910-763-3424",
            "fax_number": "910-815-0367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1214 KIDDER ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284015918",
            "telephone_number": "910-763-3424",
            "fax_number": "910-815-0367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL ENTERPRISES OF WILMINGTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2019-03-07",
        "status": "A",
        "authorized_official_last_name": "HOOVER",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "LEON",
        "authorized_official_title_or_position": "IDD SERVICES COORDINATOR",
        "authorized_official_telephone_number": "910-763-3424",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BS, QP"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NC",
            "license": "MHL-065-099",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MENTAL HEALTH LICENSE #",
            "identifier": "MHL-065-099",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Coastal Chiropractic Center PA
• Coastal Community Care Services LLC
• Coastal Connections Collective, PLLC
• Coastal Counseling Associates, PLLC
• Coastal Dermatology & Surgery Center, PA
• Coastal Eyeworks Incorporated (Ogden Optical Center)
• Coastal Family Practice & Internal Medicine
• Coastal Healing PA
• Coastal Hearing Solutions, Inc.
• Coastal Home Healthcare

• Community/Behavioral Health Agency in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.