Coastal ER II, LLC

Primary specialty

Emergency Care Clinic/CenterTaxonomy code 261QE0002X

Legal business name

COASTAL ER II, LLC

Doing business as

Physicians Premier Emergency Room

Practice address

4141 S Staples St
Suite 106
Corpus Christi, TX 78411-2105

Phone

(361) 991-0911

Fax

(512) 852-4625

NPI assigned

Nov 4, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Christopher Kwon, MD

Title

LLC Board Member

Phone

(361) 991-0911

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Physicians Premier Emergency Room Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Hospital certification: CCN 670162

Legal name

PHYSICIANS PREMIER EMERGENCY ROOM

Certification status

Terminated Voluntary: merger or closure, Jan 1, 2022

Provider type (POS)

Hospital – Short-term

Participating since

Apr 28, 2020

Last certification

Apr 28, 2020

Beds

1

Ownership / control type

Private (not for profit)

Facility address

4141 S Staples St Suite 106
Corpus Christi, TX 78411

Locations

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

{
    "created_epoch": "1415059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704931200000",
    "number": "1164827093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6040",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784666040",
            "telephone_number": "361-991-0911",
            "fax_number": "512-852-4625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4141 S STAPLES ST",
            "address_2": "SUITE 106",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784112105",
            "telephone_number": "361-991-0911",
            "fax_number": "512-852-4625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL ER II, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-04",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A",
        "authorized_official_last_name": "KWON",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "LLC BOARD MEMBER",
        "authorized_official_telephone_number": "361-991-0911",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TDSHS FSEC LICENSE",
            "identifier": "160169",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Physicians Premier Emergency Room",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Physicians Premier Emergency Room",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Coastal Care, Inc.
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• Coastal Community Direct Primary Care
• Coastal Counseling Services, LLC
• Coastal ER I, LLC (Physicians Premier Emergency Room)
• Coastal ER IV LLC
• Coastal ER V, LLC (Physicians PremiER)
• Coastal Family Medicine Associates, PA (Bayside Medical Center)
• Coastal First Assisting LLC
• Coastal Living, Inc.

• Emergency Care Clinic/Center in Corpus Christi, TX
• Providers in Corpus Christi, TX by specialty
• Emergency Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.