Organization Active NPI

Coastal Walk in

  • Urgent Care Clinic/Center
  • Dover, DE
National Provider Identifier
1235812876
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
COASTAL WALK IN
Practice address
4601 South Dupont Highway
St 1
Dover, DE 19901
Phone
(302) 698-1100
NPI assigned
Aug 10, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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

Authorized official

Name
Ronnie Diem, PA-CNPI 1932164324
Title
Owner
Phone
(302) 331-9026

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

4601 South Dupont Highway
St 1
Dover, DE 19901

Mailing address

4601 South Dupont Highway
St 1
Dover, DE 19901
Phone (302) 331-9026

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231016003294 DE Part B Supplier - Clinic/Group Practice 0244685956 Receives reassigned benefits from 6 practitioners
Practice locations: Harrington, DE

National Provider Directory

National Provider Directory

Locations

16479 S DuPont Hwy
Harrington, DE 19952
Phone (302) 587-5017

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1691625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693872000000",
    "number": "1235812876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 SOUTH DUPONT HIGHWAY",
            "address_2": "ST 1",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "19901",
            "telephone_number": "302-331-9026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 SOUTH DUPONT HIGHWAY",
            "address_2": "ST 1",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "19901",
            "telephone_number": "302-698-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL WALK IN",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-10",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A",
        "authorized_official_last_name": "DIEM",
        "authorized_official_first_name": "RONNIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "302-331-9026",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; 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.