NPIMap

Organization Active NPI

Coastal Healthcare Partners, LLC

  • General Practice Physician
  • Palm Coast, FL
National Provider Identifier
1053762740
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME101968 Issued in FL
Legal business name
COASTAL HEALTHCARE PARTNERS, LLC
Practice address
50 Leanni Way
Suite D1
Palm Coast, FL 32137
Phone
(386) 283-5997
Fax
(386) 283-5652
NPI assigned
Jun 24, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Michael Allen Osborne, DCNPI 1205012689
Title
Owner
Phone
(386) 283-5997

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X ME101968 FL Primary

Addresses

Primary practice location

50 Leanni Way
Suite D1
Palm Coast, FL 32137

Mailing address

50 Leanni Way
Suite D1
Palm Coast, FL 32137
Phone (386) 283-5997

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170710001136 FL Part B Supplier - Clinic/Group Practice 0244509149 Receives reassigned benefits from 8 practitioners
Practice locations: Deland, FL; Palm Coast, FL; Orange City, FL; Daytona Beach, FL

National Provider Directory

National Provider Directory

Locations

819 W Beresford Rd
Deland, FL 32720
Phone (386) 218-3799

50 Leanni Way
Unit D1
Palm Coast, FL 32137
Phone (386) 283-5997

Practitioners & affiliated clinicians

Practitioners 10

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

NPI Registry JSON

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

{
    "created_epoch": "1466726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1053762740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 LEANNI WAY",
            "address_2": "SUITE D1",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "32137",
            "telephone_number": "386-283-5997",
            "fax_number": "386-283-5652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 LEANNI WAY",
            "address_2": "SUITE D1",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "32137",
            "telephone_number": "386-283-5997",
            "fax_number": "386-283-5652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL HEALTHCARE PARTNERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-24",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "OSBORNE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-283-5997",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME101968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Coast, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.