Coastal Medical Services, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

005445 Issued in TX

Legal business name

COASTAL MEDICAL SERVICES, INC.

Practice address

8303 Southwest Fwy Ste 820
Houston, TX 77074-1638

Phone

(713) 771-8470

Fax

(713) 771-8474

NPI assigned

Oct 26, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Imeh Okpon Jack, RN

Title

Don/Alternate Administrator

Phone

(713) 771-8470

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Home health agency certification: CCN 678086

Legal name

COASTAL MEDICAL SERVICES INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Nov 28, 1995

Last certification

Jul 18, 2019

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Enrollment address

7070 Knights CT
Ste 604
Missouri City, TX 77459-5229

Listed as

Coastal Medical Services IncCCN 678086

Overall star rating

3.5 of 5

Ownership

Proprietary

Certified

Nov 28, 1995

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328140800000",
    "number": "1144305004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8303 SOUTHWEST FWY STE 820",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770741638",
            "telephone_number": "713-771-8470",
            "fax_number": "713-771-8474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8303 SOUTHWEST FWY STE 820",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770741638",
            "telephone_number": "713-771-8470",
            "fax_number": "713-771-8474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL MEDICAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2012-02-02",
        "status": "A",
        "authorized_official_last_name": "OKPON JACK",
        "authorized_official_first_name": "IMEH",
        "authorized_official_title_or_position": "DON/ALTERNATE ADMINISTRATOR",
        "authorized_official_telephone_number": "713-771-8470",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "005445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005445",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Coastal EMS, Inc.
• Coastal Eye Associates
• Coastal Eye Associates, PLLC
• Coastal Medical Group
• Coastal Medical Services and Staffing
• Coastal Nephrology Associates PLLC
• Coastal Surgical Group
• Coastal Texas Cardiovascular Inc
• Coastal-Inpatient Nephrologist PLLC
• Coastal-Kidney Treatment Centers PLLC

• Home Health Agency in Houston, TX
• Providers in Houston, TX by specialty
• Home Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.