Coastal Breeze Chiropractic

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2207 Issued in NC

Legal business name

COASTAL BREEZE CHIROPRACTIC

Practice address

109 Causeway Dr Ste 6
Ocean Isle Beach, NC 28469-7523

Phone

(910) 575-7809

NPI assigned

Nov 7, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Russell Duncan Edgar, D.C.NPI 1366411720

Title

President

Phone

(910) 575-7809

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Russell D Edgar, D.C.

  • Chiropractor
  • Ocean Isle Beach, NC
  • NPI 1366411720
  NPD (past) Authorized official

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186444800000",
    "number": "1154490688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6931",
            "city": "OCEAN ISLE BEACH",
            "state": "NC",
            "postal_code": "284690931",
            "telephone_number": "910-575-7809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 CAUSEWAY DR STE 6",
            "city": "OCEAN ISLE BEACH",
            "state": "NC",
            "postal_code": "284697523",
            "telephone_number": "910-575-7809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL BREEZE CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-08-07",
        "status": "A",
        "authorized_official_last_name": "EDGAR",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "DUNCAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-575-7809",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7908776",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandra Robertson Brown, LCSW
• Brunswick Care, LLC
• By the Beach Chiropractic Health Center P. C.
• Gina Kay Cancilla
• Carolina Urology Clinic, PA
• Coastal Primary Care and Wellness, PLLC
• Crista Colaneri, ATC
• Columbus Regional Health Network
• Nicole Cumbee, DPT
• Jennifer L Deluca-Stafford, DC

• Chiropractor in Ocean Isle Beach, NC
• Providers in Ocean Isle Beach, NC by specialty
• Chiropractor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2007; 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.