NPIMap

Organization Active NPI

Coastal Carolina Foot & Ankle Associates PA

  • Foot & Ankle Surgery Podiatrist
  • Wilmington, NC
National Provider Identifier
1205885159
Registry record updated Sep 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
230 Issued in NC
Legal business name
COASTAL CAROLINA FOOT & ANKLE ASSOCIATES PA
Practice address
1602 Doctors Cir
Wilmington, NC 28401-7406
Phone
(910) 343-8889
Fax
(910) 343-9990
NPI assigned
May 9, 2006
Last updated
Sep 17, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2013

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

Authorized official

Name
Mrs. Kathy N Walker
Title
Practice Administrator
Phone
(910) 343-8889

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0103X 230 NC Primary
Foot & Ankle Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0103X 449 NC

Addresses

Primary practice location

1602 Doctors Cir
Wilmington, NC 28401-7406

Mailing address

1602 Doctors Cir
Wilmington, NC 28401-7406
Phone (910) 343-8889

Other identifiers 5

IdentifierTypeStateIssuer
2347992OtherNCMEDICARE PTAN
0231ROtherNCBCBS NC
B1115OtherNCMEDCOST
890231RMedicaidNC
DR7169OtherNCRAILROAD MEDICARE PTAN

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379376000000",
    "number": "1205885159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 DOCTORS CIR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017406",
            "telephone_number": "910-343-8889",
            "fax_number": "910-343-9990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 DOCTORS CIR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017406",
            "telephone_number": "910-343-8889",
            "fax_number": "910-343-9990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL CAROLINA FOOT & ANKLE ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2013-09-17",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "910-343-8889",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NC",
            "license": "230",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NC",
            "license": "449",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "2347992",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "0231R",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "B1115",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890231R",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "DR7169",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2013; 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.