Coastal Medical Specialists in Lung & Critical Care, PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

049393 Issued in GA

Legal business name

COASTAL MEDICAL SPECIALISTS IN LUNG & CRITICAL CARE, PC

Practice address

411 Stephenson Ave
Savannah, GA 31405-5968

Phone

(912) 354-7679

Fax

(912) 354-4018

NPI assigned

Apr 12, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Adewumi O Oguntumibi, M.D.

Title

Ceo/MD

Phone

(912) 354-7679

Specialties & licenses 1

Addresses

Other identifiers 11

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Tax ID family

Coastal Med Spec in Lung Cri2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Coastal Medical Specialists

  • Specialist
  • Hinesville, GA
  • NPI 1952579666
  NPD tax ID

Locations

Practitioners 5

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

• Adewumi Olusegun Oguntunmibi, MD

  • Specialist
  • Savannah, GA
  • NPI 1083706055
  Medicare reassignment NPD
• Sylvonne Kenyatta Cox, PA-C

  • Medical Physician Assistant
  • Austell, GA
  • NPI 1992863385
  NPD (past)
• Nicole Whitis, PA

  • Medical Physician Assistant
  • Savannah, GA
  • NPI 1801141254
  NPD (past)
• Jennifer Lynn Wooten

  • Family Nurse Practitioner
  • Savannah, GA
  • NPI 1316505373
  NPD (past)
• Jawana Wright

  • Family Nurse Practitioner
  • Savannah, GA
  • NPI 1902642770
  NPD (past)

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386028800000",
    "number": "1194949248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 STEPHENSON AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314055968",
            "telephone_number": "912-354-7679",
            "fax_number": "912-354-4018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 STEPHENSON AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314055968",
            "telephone_number": "912-354-7679",
            "fax_number": "912-354-4018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL MEDICAL SPECIALISTS IN LUNG & CRITICAL CARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2013-12-03",
        "status": "A",
        "authorized_official_last_name": "OGUNTUMIBI",
        "authorized_official_first_name": "ADEWUMI",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "CEO/MD",
        "authorized_official_telephone_number": "912-354-7679",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "049393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00900797H",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00900798C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85003028G",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000900798I",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00900798G",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00900798H",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "930105831",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00900798D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00900798E",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00900798F",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000900798M",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Coastal Home Care, LLC
• Coastal Home Respiratory LLP
• Coastal Imaging Solutions LLC
• Coastal Innovative Counseling Solutions, LLC
• Coastal Medical Services LLC
• Coastal Neurosurgical Consultants, LLC
• Coastal Nutrition Consulting LLC
• Coastal Pain Relief Consultants, LLC
• Coastal Pediatric Therapies, LLC
• Coastal Pediatrics, LLC

• Specialist in Savannah, GA
• Providers in Savannah, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.