Coastal Rehabilitation Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

COASTAL REHABILITATION INC

Practice address

501 Main Street
Gatesville, NC 27938

Phone

(252) 357-1011

Fax

(252) 357-0048

NPI assigned

Apr 17, 2007

Last updated

Apr 20, 2008By 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. Sherman B Blystone Jr., PTNPI 1801953765

Title

Owner

Phone

(252) 338-2114

Specialties & licenses 2

Addresses

Other identifiers 4

Tax ID family

Coastal Rehab Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Coastal Rehabilitation Inc

  • Physical Therapist
  • Elizabeth City, NC
  • NPI 1457418311
  NPD tax ID
• Coastal Rehabilitation Inc

  • Physical Therapist
  • Elizabeth City, NC
  • NPI 1871737874
  NPD tax ID

Locations

Practitioners 1

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.

• Sherman B Blystone Jr., PT

  • Physical Therapist
  • Elizabeth City, NC
  • NPI 1801953765
  Authorized official Same address or phone

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1073739561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MEDICAL DRIVE",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279693361",
            "telephone_number": "252-338-2114",
            "fax_number": "252-338-2115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 MAIN STREET",
            "city": "GATESVILLE",
            "state": "NC",
            "postal_code": "27938",
            "telephone_number": "252-357-1011",
            "fax_number": "252-357-0048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL REHABILITATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "BLYSTONE",
        "authorized_official_first_name": "SHERMAN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-338-2114",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FACILITY",
            "identifier": "0002W",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7700350",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "07763",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7200037",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abigail Claudia Bivans, PA-C
• Julia Blackwell, CRNP
• James Wayne Blanton, PAC
• Rhonda S Brown
• Carolinas Home Care Inc
• County of Gates (Gates County Rescue Squad)
• Daughters of Zion Restoration Therapy Inc
• Down East Healthcare LLC (Down East Health and Rehabilitation Center)
• Down East Living & Rehab Center, LLC
• Down East Living & Rehab Center, LLC (Gates Health and Rehabilitation Center)

• Physical Therapist in Gatesville, NC
• Providers in Gatesville, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.