Coastal Primecare FL Group

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

COASTAL PRIMECARE FL GROUP

Practice address

8291 Dani Dr Ste 100
Fort Myers, FL 33966-8021

Phone

(239) 931-6049

NPI assigned

Feb 18, 2021

Organization subpart

No

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

Authorized official

Name

Mrs. Angelia Sakyi-Agyekum, APRNNPI 1316422199

Title

Owner

Phone

(904) 437-1529

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Coaastal Primecare Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

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

• Angelia Lynette Sakyi-Agyekum, PA

  • Physician Assistant
  • Fort Myers, FL
  • NPI 1316422199

  FL

  Medicare reassignment Authorized official
• Owusu Sakyi-Agyekum

  • Pharmacist
  • Fort Myers, FL
  • NPI 1881283885

  FL

  Medicare reassignment NPD
• Amanda Axel

  • Physician Assistant
  • Fort Myers, FL
  • NPI 1508334210

  FL

  Medicare reassignment

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

{
    "created_epoch": "1613606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613606400000",
    "number": "1093308355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8291 DANI DR STE 100",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339668021",
            "telephone_number": "239-931-6049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8291 DANI DR STE 100",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339668021",
            "telephone_number": "239-931-6049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL PRIMECARE FL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-18",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A",
        "authorized_official_last_name": "SAKYI-AGYEKUM",
        "authorized_official_first_name": "ANGELIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-437-1529",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1316422199",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "AthenaHealth",
            "affiliation": "N",
            "endpointDescription": "EMR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EMR",
            "address_1": "8291 Dani Dr Ste 100",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339668021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Coaastal Primecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Patricia Coccoma, EDD LCSW

• All providers in Fort Myers, FL
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.