NPIMap

Organization Active NPI

Coastal Integrative Healthcare Inc

  • Nurse Practitioner
  • Edgewater, FL
National Provider Identifier
1093126203
Registry record updated May 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
COASTAL INTEGRATIVE HEALTHCARE INC
Practice address
315 N Ridgewood Ave
Edgewater, FL 32132-1617
Phone
(386) 427-8403
NPI assigned
May 12, 2014
Last updated
May 14, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2014

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

Authorized official

Name
Timothy M Steflik, DCNPI 1285919456
Title
Owner
Phone
(386) 427-8403

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X Primary
Chiropractor 111N00000X

Addresses

Primary practice location

315 N Ridgewood Ave
Edgewater, FL 32132-1617

Mailing address

315 N Ridgewood Ave
Edgewater, FL 32132-1617
Phone (386) 427-8403

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140909002574 FL Part B Supplier - Clinic/Group Practice 2264651074 Receives reassigned benefits from 20 practitioners
Practice locations: Debary, FL; Edgewater, FL; Palm Coast, FL
O20150819007210 FL DME Supplier - Medical Supply CompanyDME Supplier - Medical Supply Company With Orthotic Personnel 2264651074 Practice locations: Edgewater, FL

National Provider Directory

National Provider Directory
Tax ID family
Coastal Integrative Healthcare Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

75 Fox Ridge Ct
Ste G
Debary, FL 32713
Phone (386) 216-2811

315 N Ridgewood Ave
Edgewater, FL 32132
Phone (386) 427-8403

938 Saxon Blvd
Ste 103E
Orange City, FL 32763
Phone (386) 845-3031

3149 Lackland Rd
Ste 4
Fort Worth, TX 76116

Practitioners & affiliated clinicians

Practitioners 23

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.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1399852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400025600000",
    "number": "1093126203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 N RIDGEWOOD AVE",
            "city": "EDGEWATER",
            "state": "FL",
            "postal_code": "321321617",
            "telephone_number": "386-427-8403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 N RIDGEWOOD AVE",
            "city": "EDGEWATER",
            "state": "FL",
            "postal_code": "321321617",
            "telephone_number": "386-427-8403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL INTEGRATIVE HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-12",
        "last_updated": "2014-05-14",
        "status": "A",
        "authorized_official_last_name": "STEFLIK",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-427-8403",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2014; 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.