NPIMap

Organization Active NPI

Coastal Childrens Services PLLC

  • Pediatric Gastroenterology Physician
  • Lumberton, NC
National Provider Identifier
1124371646
Registry record updated Oct 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
Legal business name
COASTAL CHILDRENS SERVICES PLLC
Practice address
400 Liberty Hill Rd
Lumberton, NC 28358-2446
Phone
(910) 772-9202
Fax
(910) 772-9452
NPI assigned
Oct 22, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2012

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

Authorized official

Name
Dr. Fernando R Moya, MD
Title
President
Phone
(910) 667-5011

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0206X Primary

Addresses

Primary practice location

400 Liberty Hill Rd
Lumberton, NC 28358-2446

Mailing address

1915 Glen Meade Rd
Wilmington, NC 28403-6024
Phone (910) 772-9202

Other names 1

  • CCS Lumberton Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Coastal Childrens Services PLLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1350864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350864000000",
    "number": "1124371646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 GLEN MEADE RD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036024",
            "telephone_number": "910-772-9202",
            "fax_number": "910-772-9452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 LIBERTY HILL RD",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283582446",
            "telephone_number": "910-772-9202",
            "fax_number": "910-772-9452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL CHILDRENS SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-22",
        "last_updated": "2012-10-22",
        "status": "A",
        "authorized_official_last_name": "MOYA",
        "authorized_official_first_name": "FERNANDO",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-667-5011",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CCS Lumberton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lumberton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; 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.